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Life Health > Health Insurance > Health Insurance

Feds wrestle with PPACA fraud threat

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WASHINGTON (AP) — Warning to seniors on Medicare: If someone asks for your personal information for a state insurance exchange under the new health care law, he’s probably a crook. Those exchanges don’t apply to seniors.

No consumer, young or old, should give out medical information or pay up-front “enrollment” fees, the government says.

Those are just two of the scams that federal officials anticipate as state insurance exchanges ramp up under the Patient Protection and Affordable Care Act (PPACA).

On Oct. 1, millions of people without access to job-based health care will be able to enroll online through new state insurance markets for coverage effective at the start of next year. Adding millions more people to the health care system is bound to create new opportunities for identity thieves and scam artists.

The Obama administration on Wednesday began a high-level effort to reassure Americans about the privacy and security of the information submitted under PPACA, hoping to blunt complaints from Republican opponents that not enough is being done to protect consumer data.

A toll-free telephone number (800-318-2596, TTY 855-889-4325) will connect consumers to federal call centers for reporting fraud or attempted identity theft. Officials also plan to promote several other initiatives, including a new computer system that will verify Americans’ identities to prevent taxpayer-funded subsidies from going to criminals. An education blitz will seek to warn consumers what scams to be on the lookout for.

Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius, Federal Trade Commission chairwoman Edith Ramirez and other federal and state officials met Wednesday at the White House to discuss the security measures and promote the anti-scam initiatives.

Events later in the week at the Justice Department and at the Federal Trade Commission are designed to reassure Americans that their personal information will be safe — and are aimed at promoting ways to report criminal activity. Consumer fraud experts from state and federal agencies will also meet regularly and notify local law enforcement about what to look for as new scams crop up.

The law’s Republican opponents, including Florida Gov. Rick Scott, have recently warned of lax security in relaying personal information such as Social Security numbers, birth dates and income statements, as people sign up under the health care law.

Attorneys general in 13 states sent a letter to Sebelius last month questioning whether there will be enough protection of consumer data in the program, and Republicans from around the country have questioned the system’s security and privacy safeguards.

Senior administration officials said the efforts announced Wednesday were planned before the GOP attack on security in the state exchanges.

In Chicago, one advocate said that legitimate door-to-door outreach to inform people about PPACA may open up opportunities for swindlers.

“I don’t know how we’re going to distinguish between legitimate outreach and scams,” said Erin Weir of AgeOptions, suburban Cook County’s lead agency on aging. “I am being told that legitimate people will have IDs and badges. But a savvy scam artist could mimic something like that.”

Federal health officials say they’ve worked with personal information in the Medicare and Medicaid programs for decades and note the new technology infrastructure was designed to meet federal and health care industry standards for data security.

Kennedy reported from Miami. Associated Press writer Carla K. Johnson in Chicago contributed to this report.

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