One Thing Congress Can Agree on: Shielding Seniors From Medicare Fraud

An auxiliary nurse assists a patient in a geriatric unit at the hospital in Angers, western France, on October 23, 2013. The Angers hospital employs 6,000 people including 980 doctors.
National Journal
Clara Ritger
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Clara Ritger
May 1, 2014, 6:21 a.m.

There is one solu­tion to fight­ing Medi­care fraud that most law­makers can agree on: Re­move seni­ors’ So­cial Se­cur­ity num­bers from their Medi­care cards to stop iden­tity theft.

But they can’t agree with fed­er­al agen­cies on how to pay for it.

The House Ways and Means Com­mit­tee held a meet­ing Wed­nes­day to dis­cuss the best way to pro­tect seni­ors from theft and ab­use. Two dif­fer­ent solu­tions have been pro­posed: an out­right re­quire­ment that the Cen­ters for Medi­care and Medi­caid Ser­vices take the num­bers off of the cards, and an al­tern­at­ive to the cur­rent cards — a “smart card,” if you will — that con­tains the data se­curely.

Yet neither has been en­acted. Why?

Money. To change the cur­rent sys­tem, which ser­vices roughly 50 mil­lion seni­ors, CMS would need a hefty sum. There’s the over­head of pro­du­cing new cards and, if the smart cards were ad­op­ted, edu­cat­ing seni­ors and phys­i­cians about how to use their new pieces of plastic.

“While [CMS] agrees that re­mov­ing the So­cial Se­cur­ity num­bers from the Medi­care card is an ap­pro­pri­ate step to re­du­cing the risk of iden­tity theft, CMS can­not make a de­cision to pro­ceed uni­lat­er­ally,” a CMS of­fi­cial said in an email. “CMS, the So­cial Se­cur­ity Ad­min­is­tra­tion, and the Rail­road Re­tire­ment Board must all agree to pro­ceed with the ini­ti­at­ive, and to con­sider all ex­ist­ing work­loads and pri­or­it­ies in light of the fund­ing that is avail­able for such a ma­jor pro­ject.”

The Gov­ern­ment Ac­count­ab­il­ity Of­fice is re­view­ing the smart-card pro­pos­al — re­tir­ing Re­pub­lic­an Rep. Jim Ger­lach’s Medi­care Com­mon Ac­cess Card Act — and is ex­pec­ted to com­plete its ana­lys­is of the ad­min­is­trat­ive and cost bur­den to en­act the pro­gram by the end of the year.

It’s not clear the GAO re­port will re­solve the dis­agree­ment over fund­ing for re­mov­ing So­cial Se­cur­ity num­bers from cards, though. Ac­cord­ing to an aide for Re­pub­lic­an Rep. Sam John­son, who is co­spon­sor­ing the bi­par­tis­an bill to re­move So­cial Se­cur­ity num­bers from the cur­rent cards, CMS wants an ap­pro­pri­ation but Con­gress thinks the agency can carry out the change in a fisc­ally re­spons­ible fash­ion us­ing its own re­sources.

“CMS has been work­ing with the com­mit­tee to find a mu­tu­ally ac­cept­able solu­tion,” a spokes­man said in an email.

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