- Published on Tuesday, 07 January 2014 15:30
- Written by Super User
RALEIGH, N.C. : January 3, 2014 - Today, the Department of Health and Human Services' Acting Medicaid Director Sandra Terrell released the following statement:
Effective January 1, due to new eligibility rules, 70,253 children were switched from NC Health Choice to Medicaid. As a result, the N.C. Department of Health and Human Services issued new Medicaid cards to these affected recipients who transitioned from NC Health Choice to Medicaid.
The Department of Health and Human Services has determined 48,752 of these new Medicaid cards were mailed to the incorrect recipients. The incorrect card shows the child's name, Medicaid identification number, date of birth and primary care physician.
The Department has begun a careful review of this incident to determine how it occurred and to ensure personal information is protected. DHHS knows exactly which Medicaid cards were sent to which addresses, and is rapidly working to issue correct Medicaid cards.
This incident does not affect Medicaid coverage, and benefits are not affected. Medicaid recipients who have received incorrect Medicaid cards will be sent a correct Medicaid card with specific instructions on what to do with the incorrect Medicaid card. In the meantime, children needing services without a correct Medicaid ID card can use their NC Health Choice ID number or card, which is still valid. Providers are also able to verify eligibility in order to deliver services.
The Department of Health and Human Services takes the privacy of Medicaid recipients very seriously and is working to put measures in place to monitor the use of affected Medicaid cards for potential fraud. We regret this incident occurred and are working to ensure it is corrected as soon as possible.
If individuals have questions about this incident, they are advised to call the DHHS Customer Service Center Number located on the back of their Medicaid card, 1-800-662-7030.
On January 4th, Department of Health and Human Services Acting Medicaid Director Sandra Terrell released the following information regarding the incident which incorrectly mailed 48,752 Medicaid cards to wrong addresses:
• Effective January 1, due to new eligibility rules and requirements under the Affordable Care Act (Obamacare), 70,253 children were switched from NC Health Choice to Medicaid. As a result, the N.C. Department of Health and Human Services had to issue new Medicaid cards to these children, and it has been determined that 48,752 of them were mailed to the incorrect recipients.
• DHHS mailed the Medicaid cards to incorrect recipients on Monday, December 30, 2013. The incorrect card shows the child's name, Medicaid identification number, date of birth and primary care physician. On Tuesday, December 31 (New Year's Eve), staff within the Medicaid Division and NCFAST first received reports that some recipients received incorrect Medicaid cards. Staff from within the Medicaid Division sent an automated message to all county departments of social services informing them that some Medicaid cards had been issued with incorrect information. DHHS leadership was informed of the issue on Thursday, January 2, 2014 and requested an analysis to determine the extent of the problem and its cause. On Thursday, after an analysis of the issue, staff preliminarily determined that potentially 48,752 Medicaid cards were incorrect. This number was confirmed and validated on the morning of Friday, January 3, 2014. The Governor was first informed Thursday evening and received updates on Friday.
• Staff at the Department of Health and Human Services is working through the weekend to continue conducting a full-scale review of this incident and to get people their correct Medicaid cards as soon as possible. Additionally, DHHS is meeting its legal obligations when a potential HIPAA breach is identified. Federal laws and rules require that DHHS go through an analysis to first determine this incident meets the legal requirements to be considered a breach of protected health information. If confirmed, HIPAA breaches must be reported within 60 days of the incident. DHHS privacy and security staff continue to work on that assessment through the weekend as a part of our comprehensive review.
• In terms of next steps, Medicaid recipients will be issued new Medicaid cards with new Medicaid ID numbers as soon as possible. By issuing new Medicaid ID numbers, the mistakenly sent Medicaid cards will be invalid. Issuance of a new Medicaid number will mitigate potential misuse of the incorrectly issued cards. Additionally, the Medicaid Division will flag the affected Medicaid ID cards within DHHS' computer systems to treat them with extra scrutiny and caution. DHHS will be alerted if those compromised cards are used.
DHHS is working to notify the public, legislators, providers and affected recipients as soon as more information is available. Affected recipients can call the Customer Service Center at 1-800-662-7030 during normal business hours on Monday-Friday if they have any questions or concerns.
On January 6th, Terrell released the following information regarding the incorrect mailing of 48,752 Medicaid cards to the wrong addresses:
• After a review of the incident, it has been determined that some Medicaid cards were incorrectly sent because of human error in computer programming and the quality assurance process in printing the new Medicaid identification cards. These new cards were printed for children switched from NC Health Choice to Medicaid because of new eligibility rules and requirements under the Affordable Care Act (Obamacare). A program was developed to extract the information from the eligibility database to generate the mailing, but utilized the incorrect name and address for the parent or responsible adult.
• The incorrect card shows the child's name, Medicaid identification number, date of birth and primary care physician's name and physician's address. No Social Security numbers were released.
• The parent or responsible adult who received an incorrect card is being advised to immediately destroy it by shredding or cutting it into small pieces.
They are also being advised that they can turn in the card to their county department of social services if they prefer. A directory of the county social services offices can be found here: http://www.ncdhhs.gov/dss/local/
A letter will be mailed this week to the parent or responsible adult of each impacted recipient that explains the steps DHHS is taking to issue new Medicaid ID numbers and cards to those affected recipients. That letter will also explain what to do until the new Medicaid card is received.
In approximately three weeks, each impacted Medicaid eligible recipient will be mailed a new Medicaid ID card with a new Medicaid ID number printed on it. Issuing new Medicaid ID numbers will mitigate misuse. Until a new Medicaid ID card is issued, Medicaid eligible children impacted by this incident may continue to access medical services by using their NC Health Choice ID number or card.
DHHS has also communicated with providers and provider associations to remind them they must verify a Medicaid beneficiary's eligibility and identity each time a service is rendered. DHHS will also flag the affected Medicaid ID numbers within its computer systems to carefully monitor their use.
DHHS Secretary Aldona Wos has asked the state Office of Information Technology Services to conduct an external review of the processes and procedures that led to this HIPAA breach to ensure a similar incident cannot happen again. In addition, she instructed DHHS' Office of Human Resources to conduct a personnel investigation into this incident.
DHHS has notified the Office for Civil Rights of the U.S. Department of Health and Human Services, as well as the Centers for Medicare & Medicaid Services, of this HIPAA breach and will be providing formal letters of notification to affected individuals.
DHHS understands parents and responsible adults are concerned about unauthorized activity on the child's accounts. DHHS will send impacted recipients statements of Medicaid services rendered using their Medicaid ID number. This will help families to know whether the child's Medicaid ID number was misused.
If affected individuals are concerned about credit fraud, they may contact any of the following credit bureaus to ask that a fraud alert be placed on their account:
P.O. Box 740241
Atlanta, GA 30374-0241
P.O. Box 9532
Allen, TX 75013
P.O. Box 6790
Fullerton, CA 92834-6970
If incorrect activity appears on personal credit reports, file an identity theft report with the local police or sheriff's department. Copies of the police report may be needed to clear issues with credit agencies.
To obtain more information about preventing identity theft, contact the Federal Trade Commission or the North Carolina Attorney General's Office at:
• Federal Trade Commission Consumer Response Center, 600 Pennsylvania Avenue, NW, Washington DC 20580, 877-438-4338, www.ftc.gov
• Consumer Protection Division, NC Attorney General's Office, 9001 Mail Service Center, Raleigh NC 27699-9001, 877-566-7226, www.ncdoj.gov
If parents or responsible adults of affected recipients have any questions or concerns about this matter, they can contact the DHHS Customer Service Center 1-800-662-7030 during normal business hours.
Source: NC Department of Health and Human Services.