10:06AM EDT October 10. 2012 - WASHINGTON
-- More than a quarter-million Medicare beneficiaries are potential
victims of identity theft and hampered in getting health care benefits
because the government won't issue new IDs, according to an
investigation report released today.
Medicare officials say it's
too expensive and too many agencies are involved to reissue those
numbers to patients victimized by identity theft — about 284,000
beneficiaries, according to a report by the Department of Health and
Human Service's inspector general.
Beneficiary numbers are
directly connected to a patient's Social Security number, and the
government is unable to create a new Social Security number for a
patient whose Medicare identity has been stolen, according to the
report, which was obtained by USA TODAY.
And beneficiaries can do
little more than report abuse of their beneficiary numbers because the
government does not provide them with updates about investigations or
amend their records with correct billing information. That,
investigators say, slows down access to care.
The Centers for
Medicare and Medicaid Services (CMS) "should mitigate the damage of
medical identity theft by ensuring that beneficiaries retain their
access to services if their Medicare numbers have been misused by
others," the report states.
Investigators suggested that the CMS,
which administers Medicare, place an indicator in breached records or
records known to have been used fraudulently so claims processors know
when a legitimate claim should go through. The agency agreed to consider
that suggestion, the report said.
The report also said the
government should find a way to issue new numbers, even if it means
moving away from using Social Security numbers.
Investigators also
found that though the government has created a database that includes
the 284,000 breached or stolen beneficiary numbers, contractors have not
received guidance about what to do with that list. In some cases,
contractors continue to send out government checks even after the
numbers have been compromised.
The government said the system is being fixed now.
Medicare
should also correct beneficiaries' billing records when fraudulent
activity has occurred, investigators recommended, but the CMS disagreed.
"Our
major concern is that CMS's adjustment of beneficiary billing records
could have a negative impact on criminal and civil prosecutions and on
the underlying integrity of the Medicare claims processing system,"
wrote Marilyn Tavenner, acting administrator for CMS.
In 2011, the
government recovered a record-breaking $4.1 billion in health care
fraud money. Between 2009 and 2011, it collected $7.20 for every dollar
spent on fighting fraud -- a jump of $5.10 for every dollar spent
between 1997 and 2008, according to inspector general reports.
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