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Medicare mix-up impacts 15,500 patients

One phone call to the Herald & Tribune from a local resident has uncovered a “systems and printing” error affecting over 15,500 Medicare subscribers in more than 11 states.
A Birmingham, Ala., Medicare contractor — Cahaba GBA — appears to be at the root of an error that sent thousands of Medicare subscribers healthcare summary reports belonging to other patients.
Tennessee was hardest hit by the “computer glitch,” according to Medicare administrative spokesperson Lee Millman.
Other states affected include Georgia, South Carolina, Virginia, Alabama, Florida, Kentucky, Indiana, Louisiana, North Carolina and Texas.
The Herald & Tribune first reported the problem last week after being contacted by Wayne Swihart, of Gray.
Swihart told the newspaper he and his father both received someone else’s Medicare summary notices – one from Ripley and another from Memphis.
Information in the reports included names, home addresses and phone numbers, the last four digits of social security numbers, as well as details of their recent medical tests and appointments.
Following his call, the Herald & Tribune learned the Swiharts were not alone. A local husband and wife reported they had each received the wrong information, too.
After just a few more phone calls, the H&T identified at least 20 more individuals in Washington County and several other Northeast Tennessee communities who had received other people’s reports.
According to Cahaba’s website, the company has been associated with Medicare since its founding in 1966 and was awarded the contract in January 2009 from the Centers for Medicare and Medicaid Services to distribute such letters and notices for the agency.
On April 29, Millman told the Herald & Tribune she had not heard anything about the apparent problem and didn’t know what had happened. On May 3, Millman reported the mix-up was widespread.
After a subsequent request for more information about the problem, Millman e-mailed a letter dated April 27 that she said would be sent to all affected clients.
The letter reads, in part, “Cahaba GBA, a Medicare Administrative Contractor, has identified a systems and printing error that caused Medicare Summary Notices for certain beneficiaries to be mailed to other beneficiaries.
“The Centers for Medicare and Medicaid Services and Cahaba GBA are committed to ensuring that the personal information of Medicare beneficiaries is protected. Cahaba GBA has already taken actions to prevent this from happening again.”
The letter instructs recipients of the wrong summaries to shred or destroy the paperwork. “If you do not wish to do that,” the letter further explains, individuals may return the form to the address printed on the envelope.
The letter also says new MSNs will be mailed to the correct beneficiaries.
Dean and Shirley Batchelder, of Elizabethton, who had also received the wrong summaries, contacted the Herald & Tribune on Friday to report they had received the letter of explanation from Medicare.
But in the Batchelders’ minds, that still leaves a lot of questions unanswered.
“I still don’t know if someone else received my information,” Dean Batchelder said. “I guess I’ll never know. I’ll just have to keep a close eye on my bank statements and other things to make sure that if they did, they don’t try use it.”
Jonesborough resident Dick Conger called the Herald & Tribune on May 3 after reading the paper’s story to say he also got a wrong report.
Unlike Swihart’s report, Conger didn’t see a name or phone number on the form. He did say, however, the report he received was lengthy – seven pages or more – and contained the last four digits of the patient’s social security number and documentation of an individual’s recent medical treatments.
“Whoever it belonged to, it was an expensive list of treatments,” Conger said. “I realized right away it wasn’t mine so, like Mr. Swihart, I called Medicare and got right through. A lady called me back two days later and told me they were ‘having a time’ because of the mix-up. She asked me for the case number listed on the material. Then they asked me to destroy the document and… I did as she asked.”
Admittedly confused by the error, Conger says he does see a bright side.
“At age 80, this is the first mix-up in Medicare I’ve seen,” Conger said. “But my wife wondered if some malcontent was having fun with Medicare’s computer system. I never would have thought of that. I guess this world is just getting a little more complicated than it used to be.”
Nancy and Lee Hallberg, also of Jonesborough, each received two wrong summaries.
“I called Medicare,” Nancy Hallberg said. “When I told her [what happened], she said, ‘Well, that’s OK. Just destroy the papers.’ I thought that was rather strange for a government entity to be so haphazard. They took no information as to who the other names were — they were just so casual about it. It’s kind of scary.”
According to a Medicare Contractor Provider Satisfaction Survey Public Report dated Sept. 16, 2010, by Mathematica Policy Research of New Jersey, Cahaba is the lowest-ranking contractor in the Medicare system.
The report is the result of an annual survey conducted by the CMS of their providers and suppliers to measure satisfaction with contractor performance, as required by the Medicare Prescription Drug Improvement and Modernization Act of 2003.
The survey collects and analyzes information from a sample of hospitals, physicians, skilled nursing facilities, home health agencies, clinical laboratories, and other providers and suppliers.
Contractors were scored in “Overall Satisfaction,” the category that reports scores computed from a single measure. The respondent’s overall satisfaction with contractor performance; and in “Business Function Satisfaction,” which reports the mean of provider satisfaction with each business function, by contractor.
The average score for all contractors in overall satisfaction is 3.8; the average business function satisfaction score is 3.66. Cahaba scored 3.77 and 3.44, respectively.
In the Carrier category, the averages were 3.78 and 3.63. Cahaba ranked 3.58 and 3.39.