According to a recent OIG report, CMS’s internal controls did not effectively ensure the accuracy of almost $2.8 billion in advance cost-sharing reduction (CSR) payments made to ACA qualified health plan (QHP) issuers during the period of January through April 2014. As a result, the OIG recommended that CMS take a series of steps to correct is internal control deficiencies, including: providing CMS Office of the Actuary review and validation of QHP issuers’ actuarial support for index rates that CMS identifies as outliers; implementing computerized systems to maintain confirmed enrollee and payment information rather than relying on QHP issuers’ attestations in calculating payments; implementing a computerized system so state marketplaces can submit enrollee eligibility data; improving calculation of estimated advance CSR payments; and developing interim reconciliation procedures to address potentially inappropriate CSR payments. In response, CMS detailed how it is addressing or has already addressed the OIG’s recommendations.  For details, see the full report, “CMS’s Internal Controls Did Not Effectively Ensure the Accuracy of Aggregate Financial Assistance Payments Made to Qualified Health Plan Issuers Under the Affordable Care Act.”