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MEDICARE MESS: Subcontractors failed to notify Medicare of mailing mix up by deadline

According to a report created by the Center for Medicare and Medicaid Services, only one employee of a CMS subcontractor stood between a debacle and a disaster.
Recent mistakes made by Medicare Services and their contractor, Cahaba GBA of Birmingham, Ala., resulted in a systems and printing error that caused a reported 15,500 Medicare Summary Notices to be mailed to the wrong beneficiaries, including several local residents.
If not for an employee of Allison Payment Systems, Cahaba GBA’s subcontractor located in Indianapolis, nearly 200,000 MSNs would have been incorrectly circulated.
The Herald & Tribune has obtained a document created by CMS, titled “Fact Sheet/Talking Points, Misrouted Medicare Summary Notices.”
Dated May 5, the document says, “During a routine quality assurance check of the running print job on April 22, an employee of Allison Payment Systems identified a print quality issue that led to the identification of the system programming errors.”
At that point, the report says, nearly 200,000 MSNs had been incorrectly compiled. Of those, 15,500 reports had already been mailed. Upon discovery of the problem, the print/mail process was stopped.
The report also indicates there was a procedural breach in the notification policy. The sheet says that while there is a requirement to notify CMS within one hour of suspecting an information breach, that requirement was not met by Allison or Cahaba.
“Notification,” the document states, “should have been made on Friday, April 22, but was not made until Monday, April 25.”
The Herald & Tribune first learned of the misdirected Medicare summary reports last month after receiving a phone call from Gray resident Wayne Swihart.
Swihart reported that he and his father each had received someone else’s report, which revealed the last four digits of those individuals’ social security numbers, along with the subscribers’ Medicare numbers, their home addresses and phone numbers, and a detailed list of their recent medical procedures.
Both of the subscribers lived in the Memphis area.
Upon further investigation, the Herald & Tribune found several dozen other local individuals who had the same experience.
After several phone calls to Medicare officials, the H&T was able to obtain more detailed information about the scope of the misrouted MSNs.
CMS is reporting that it has alerted the HHS Computer Security Incident Response Center of the release of personal health information and is continuing to investigate the incident.
The organization also says it is preparing to notify beneficiaries whose information was released to other beneficiaries now that they know who received the misdirected MSNs.
Tennessee bore the brunt of the mishap, but other states received small numbers of misdirected reports, too. Georgia was the second most-affected state, receiving 196. South Carolina and Alabama each got 12 while Virginia, Florida, Kentucky, North Carolina and Texas remained in single digits of people affected.