Medicare Beneficiaries at Risk of Identity Theft

WASHINGTON — Social Security officials, concerned about the risk of identity theft, are calling for immediate action to remove Social Security numbers from the Medicare cards used by millions of Americans.

But Medicare officials have resisted the proposal, saying it would be costly and impractical.

In a new report, the inspector general of Social Security, Patrick P. O’Carroll Jr., says “immediate action is needed.”

“Displaying such information on Medicare cards unnecessarily places millions of individuals at risk for identity theft,” Mr. O’Carroll said. “We do not believe a federal agency should place more value on convenience than the security of its beneficiaries’ personal information.”

In a memorandum to the heads of federal departments and agencies in May 2007, Clay Johnson III, deputy director of the White House Office of Management and Budget, said they should draw up plans to “eliminate the unnecessary collection and use of Social Security numbers within 18 months.”

Social Security cannot prohibit the Medicare agency from using Social Security numbers, although Congress could do so. Federal officials say that more than 40 million people who are 65 and older or disabled have Medicare cards with Social Security numbers on them.

Charlene M. Frizzera, chief operating officer of the Centers for Medicare and Medicaid Services, played down the risk of identity theft from the misuse of Medicare cards. If the government suddenly issued new Medicare cards or identification numbers, she said, it could startle or alarm beneficiaries. “We don’t want to scare them,” Ms. Frizzera said.

Most private insurance companies have abandoned the use of Social Security numbers as identifiers because many states forbid it.

Gail K. Hillebrand, a lawyer at Consumers Union, said, “A person holding a private health insurance card now has more privacy protections than a person holding a Medicare card.”

Byron Hollis, director of the antifraud department at the Blue Cross and Blue Shield Association, said, “Medical identity theft is the fastest-growing form of health care fraud.”

To prevent such fraud, Mr. Hollis said, Blue Cross and Blue Shield plans stopped using Social Security numbers on their cards several years ago. The 39 Blue Cross and Blue Shield companies provide coverage for more than 100 million people.

Ms. Frizzera, the Medicare official, said that issuing new Medicare cards would be “a huge undertaking.” The agency would need three years to plan such a move and eight more years to carry it out, she said.

Medicare officials estimate that it would cost $500 million to change their computer systems if they issued new ID numbers to beneficiaries. Doctors, hospitals and other health care providers use those numbers in filing claims with Medicare, which pays a billion claims a year.

“Many individuals carry their Medicare cards in their wallets or purses and could become victims of identity theft should dishonest individuals steal such items or lift their Medicare number from a beneficiary card or medical document,” Mr. O’Carroll said.

With a solution years away, many individuals are taking their own precautions and signing up for LifeLock and other companies that prevents your identity from being stolen before it happens.

About LifeLock

LifeLock (www.lifelock.com) helps consumers to render their personal information useless to thieves, backing up its service with a million-dollar guarantee. LifeLock is offered to the public for just $10 per month or $110 per year. New members can get a 10% discount by entering promo code JBAZ35 at LifeLock.com.

Blue Cross Blue Shield of Illinois and Advocate Health Care renew contract through 2010

Effective June 19, 2008, Blue Cross and Blue Shield of Illinois and Advocate Health Care have announced they have reached an agreement that renews all of their contractual relationships through 2010. The newly signed contract will include all of the Advocate hospitals and expand to include Libertyville’s Condell Medical Center when its expected integration into Advocate Health Care is approved by federal and state agencies later this year.

Small Business Healthcare Sees Improvements

WASHINGTON–(BUSINESS WIRE)–The National Association for the Self-Employed (NASE) today released data from the only national survey to measure the impact of rising healthcare costs on micro-businesses and the self-employed. The survey of nearly 4,000 micro-businesses, a follow-up to research conducted in 2005, shows that high cost continues to be the most significant barrier to offering health insurance and that small businesses strongly feel they are at a disadvantage compared to their larger counterparts when it comes to access to coverage.

“While we do see some encouraging data this year, the fact remains that access to health care is the most significant issue facing this country’s smallest businesses,” said Kristie Darien, Executive Director of the NASE. “The baker, the house painter, and the 20 million other micro-businesses in the United States already are struggling to survive in this economy. These businesses could be further threatened if we cannot find a way to make insurance more affordable.”

Numbering over 24 million, micro-businesses often are cited as the drivers of America’s economic engine, creating well over a third of all new jobs. The data collected in the NASE survey were segmented to explore key differences among respondents, including number of employees and total 2007 gross sales, both critical factors in determining the impact of rising health care costs on a business.

Survey Highlights – Coverage

• About two-thirds (67%) of respondents say they have personal health insurance coverage, a notable increase from the 54.9% who reported the same in 2005.

• In a surprising shift, the percentage of responding businesses whose plans cover full-time employees dropped significantly from 46.2% in 2005 to 18.6% in 2008.

• Companies with gross sales under $50,000 experienced the greatest increase in access to health care coverage – 40% presently offer insurance compared to only 13.8% in 2005.

Survey Highlights – Cost

• More than 65% cite cost as the single most significant barrier to offering health insurance to employees.

• Results show a significant increase in the percentage spent on health insurance premiums since 2005, with median costs rising from 3.7% of total revenue to 5.5%.

• One in 10 of the 2008 respondents spend 25% or more of their gross revenue on health insurance, compared to 10.1% in 2005, representing a 48.6% increase.

• Overall, costs have increased an average of 14.7%, compared to a 20.7% increase in 2005.

• Two issues respondents feel have the greatest impact on high health care costs are “insurance companies making too much profit” (28.8%) and “doctors/hospitals charging too much for services” (21.7%).

The survey also shows that small businesses with the least end up paying the most in terms of health insurance costs. Micro-businesses grossing less than $50,000 annually spend a median of 17.6% of their gross 2007 sales on health insurance, compared to a median of only 1% spent

Michael Reese Physician Group no longer participating in BCBS of Illinois’ HMO Illinois or Blue Advantage HMO

Effective October 1, 2008 the Michael Reese Physicians Group MG-189 will no longer participate in HMO Illinois or Blue Advantage HMO networks. There are approximately 6,000 members and 63 physicians impacted as a result of this medical group closing.

Letters will be sent to these members and their employers by end of June, and will inform members of the medical group closing along with the option to select a new physician group. If a member does not select a new physician group by Friday, August 22, Blue Cross Blue Shield of Illinois will automatically reassign them to a new medical group for an effective date of 10/1/08.

Cape Radiology Group Terminates PPO Contract with Blue Cross Blue Shield of Illinois

Cape Radiology Group of Southern Illinois has terminated their PPO contract with BCBSIL. Cape Radiology Group is a group of radiologists that are on staff at the following Southern Illinois PPO Hospitals:
• Memorial Hospital – Carbondale
• Carbondale Clinic – Carbondale (This is a professional provider satellite of Memorial Hospital)
• Herrin Hospital – Herrin
• St. Joseph Hospital – Murphysboro
• Union County Hospital – Anna

Because Cape Radiology is the exclusive radiology group contracted with the above facilities, all inpatient and outpatient radiological services are subject to non-PPO benefits. The member may be responsible for the balance billing above the amount covered under their group benefit plan. Notification letters went out last week to all group and individual market members who reside in the service areas of the above hospitals. Letters are also going to all employer groups affected by their employees residency in the service areas. To find a radiologist in the BCBS IL PPO network, use the Provider Finder on www.bcbsil.com.

Additional Blue Cross Blue Shield of Illinois Vision Program changes effective July 1st, 2008

As part of our BlueExtras discount program, Blue Cross Blue Shield of Illinois has arranged a vision discount program that offers all group members discounts on eye exams, contact lenses, frames, lenses and lens add-ons.

In addition, as part of their health care benefits, HMO members have a vision benefit that provides coverage for one eye exam every 12 months for the cost of their PCP copayment, when they visit a network provider. All HMO members are eligible to receive this vision benefit, independent of any vision benefit (materials allowance) your company may have elected to provide for your employees. Effective July 1, 2008, both the HMO vision discount program and vision benefit will be administered by Davis Vision, Inc. Davis Vision began administering the vision discount program for non-HMO groups on January 1, 2008.

All group members also have access to discounts on laser vision correction through Davis Vision, featuring the TruVision network (Yes, the network Tiger Woods endorses). Members can receive discounted pricing on disposable contact lenses through Davis Vision’s Lens 1 2 3 Mail Order Contact Lens Replacement Program.

U.S. Lawmakers Block Medicare Bill Reducing Insurers’ Pay

WASHINGTON (Reuters) – A $20 billion Medicare refinancing bill, paid for mostly by reducing Medicare’s reimbursement of private health plans, was blocked by U.S. lawmakers on Thursday, raising the likelihood a version with smaller cuts will emerge.

Health insurers such as Humana Inc and UnitedHealth Group would face billions in cuts in two competing versions of the legislation that lawmakers are debating this week.

The legislators face a ticking clock to pass a bill by June 30, or doctors working in the Medicare program would face a 10 percent cut in pay — a highly unlikely outcome in an election year.

A legislative fix is needed to ward off a pending 11 percent pay cut to doctors who work with Medicare patients. Medicare is the federally run insurance plan for roughly 44 million elderly and disabled.

The bill sponsored by Montana Democrat Sen. Max Baucus and backed mostly by Democrats had more drastic cuts, but failed a key procedural vote on Thursday.

Iowa Republican Sen. Charles Grassley, has a competing version of the legislation. His plan would be less pricey, but he also backs some cuts in reimbursement to private plans.

AARP, the nation’s largest advocacy group for older Americans, said the bill would help low-income seniors. In a statement, the group said it is “disturbed” that the bill was blocked.

Scores of other health companies would also be affected by whatever bill emerges, ranging from dialysis companies such as DaVita Inc to oxygen providers such as Apria Healthcare.

Medicare is the top buyer of U.S. health-care goods and services, spending nearly $400 billion a year.

Survey: 20% of College Parents Unaware when their children are no longer covered under their health plan

According to a two recent surveys conducted by Assurant Health, students and parents might not be aware of important facts regarding their son or daughter’s health insurance eligibility. In fact, concerned parents might make this their top priority if only they knew that, as soon as their sons or daughters doffed their caps and gowns, many of these grads were no longer protected against medical catastrophes. Unfortunately, many parents are unaware that some health insurance plans stop providing coverage to adult children, even if are living at home. Plus, they don’t realize affordable, short-term medical insurance is readily available.

“It’s a shame that this lack of knowledge is putting so many young adults needlessly at risk,” said Heidi Hanstein, vice president for Assurant Health, which helped to pioneer the concept of short-term
coverage. “I’m sure many parents and grads wouldn’t take such a chance if they knew how easy it is to apply for and purchase temporary coverage.”

This disturbing news is supported by two surveys conducted by Assurant Health. Other findings included:

• Approximately 40 percent of parents mistakenly believed that adult children (ages 21 -24) living at home were covered under their health insurance plans.

• 20 percent of college parents have no idea when their health insurance will no longer cover their college-age children.

• Most believe that short-term health insurance for a healthy young adult costs more than $100/month; in fact, such policies generally cost around $50/month.

• 68 percent of the parents were not even aware of the availability of short-term health insurance.

Typically, most adult children who are students will lose their coverage when they attain a certain age, graduate or are no longer attending school on a full-time basis. Since most of these new college graduates won’t have coverage until after they have found a job, many find themselves falling through a gap in coverage. Companies such as Assurant Health can fill that gap with policies that cover periods ranging from one to twelve months in Illinois.

The enrollment process for such policies is simple and fast. Applicants can go online to answer a series of yes/no questions and coverage can begin the next day.