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Tuesday, Aug 1 2023

Full Issue

Personal Info For 612,000 On Medicare Exposed In Hack

The Centers for Medicare and Medicaid Services warned an 鈥渦nauthorized party" exploited a security vulnerability that gave them access to the data. Meanwhile, the agency is working to to smooth "conflicting" rules on data sharing during the prior authorization process.

The personal information of 612,000 Medicare beneficiaries were accessed in a sweeping data breach that affected聽what could be聽hundreds of organizations, including the government contractor, Maximus Federal Services.聽The Centers for Medicare & Medicaid Services (CMS) announced in a press release Friday that it is notifying people affected by the data breach, which could have affected information including beneficiaries, names, Social Security numbers, medical histories, diagnoses and other personal details.聽(Fortinsky, 7/31)

More Medicare updates 鈥

Lobbying groups representing different camps of the healthcare industry have come together to urge the Centers for Medicare & Medicaid Service (CMS) to reconsider 鈥渃onflicting regulatory proposals鈥 that require different electronic standards for electronic data exchanges during prior authorization. (Muoio, 7/31)

Martin鈥檚 Point Health Care Inc. will pay nearly $22.5 million to resolve allegations of submitting inaccurate codes for Medicare Advantage Plan enrollees to increase Medicare reimbursements, federal prosecutors said Monday. The U.S. attorney鈥檚 office in Maine confirmed it was the largest Medicare fraud settlement in state history. A Martin鈥檚 Point representative didn鈥檛 immediately return a phone call seeking comment on Monday. The company was accused of submitting the inaccurate diagnosis codes for Medicare Advantage Plan enrollees in Maine and New Hampshire between 2016 and 2019. (7/31)

Bon Secours Mercy Health and insurance company Anthem/Blue Cross Blue Shield didn鈥檛 reach an agreement on reimbursement rates by their deadline Monday, leaving around 6,000 Hampton Roads residents who use Medicare out of network as of Tuesday. This means that most people who have an Anthem/BCBS-managed Medicare plan and use Bon Secours Mercy Health medical services will need to find new providers or pay out of pocket. (Dix, 7/31)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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