How Identity Theft Can Harm A Senior’s Health

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On August 15, 2014, Posted by , In Home Care, By ,,, , With Comments Off on How Identity Theft Can Harm A Senior’s Health

Identity theft can do more than drain a senior’s bank account—it may also impede their ability to access important medical care, says a new government report.

Well over a quarter of a million Medicare beneficiaries have had their identities stolen over the past two years, but the Centers for Medicare and Medicaid Services (CMS) has yet to issue these elders a replacement ID, or update their accounts and billing records, according to an investigation conducted by the Department of Health and Human Services (HHS).

This means an elder could experience significant delays—and sometimes outright rejection—when seeking coverage for important medical services.

A frustrating reporting process

Outside of creating a database of ID numbers that were reported stolen, Medicare has done little to remedy the negative effects felt by beneficiaries victimized by fraud, according to the HHS report.

If a senior thinks their identity has been stolen, the only recourse they currently have is to report their suspicions to a “benefit integrity contractor” by calling 1-800-MEDICARE.

After notifying Medicare, there’s not much more an elder can do besides sit and wait.

Contractors have no obligation to follow up and update a senior on the progress of their inquiry and they may or may not decide to edit a beneficiary’s billing history to reflect counterfeit claims.

The HHS investigation found that some contractors even continue to make payments on potentially fraudulent coverage applications, which can affect a senior’s ability to obtain future care.

Slow solutions to a complex problem

Why doesn’t Medicare simply take a page out of the credit card company playbook and give beneficiaries a new number, while canceling compromised IDs?

Officials maintain that this isn’t a viable solution. Beneficiaries’ IDs are intertwined with their Social Security number and Medicare cannot intervene and generate new numbers for seniors who’ve had their identities pilfered.

The issue of disentangling an elder’s Medicare ID from their Social Security number has been brought up in the past, with cost and inconvenience cited as major barriers to making the necessary changes.

In a written response, CMS Acting Administrator, Marilyn Tavenner, communicated the organization’s agreement with four out of the five improvements suggested by the HHS Office of the Inspector General.

She says Medicare is working to improve on the usefulness of their database of stolen numbers and is trying to come up with a way to efficiently issue new IDs.

However, when it comes to the issue of striking suspicious claims from a beneficiary’s billing history, she says, “Our major concern is that adjustment of beneficiary billing records could have a negative impact on the criminal and civil prosecutions and on the underlying integrity of the Medicare claims processing system.”

Contact Pure Home Care Services at (586) 293-2457 today! If you live in Grosse Pointe or the surrounding area, we can help you care for your loved ones.

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