Electronic Medicare cards will reduce fraud

According to a report released by the Government Accountability Office, Medicare cards which are electronically readable can not only help in reducing fraud but they can also be helpful for making administrative measures more efficient. However due to reluctance being shown by the government agency which is responsible for the Medicare program, these potential benefits could be limited to a great extent.

The report which was released by the GAO in April speaks about how these electronic cards will be beneficial for the administrative efficiency of the program. The report also made predictions regarding how these cards could help in reducing fraud which is commonly associated with Medicare which includes identity theft as well as bills for patients who were never treated by doctors. At the moment, Medicare makes use of paper cards which contain the name and Medicare number of the beneficiary, what their eligibility status is and what their social security number is, all of which is used by providers to verify the information and to make payment claims. The electronic card will come in handy according to the GAO as it will provide proof that the beneficiary himself was present while receiving care. It has also been proposed that the new electronic cards should not display the social security number of the beneficiary so that he/she could be protected from potential identity theft. The report also made suggestions regarding the use of PIN numbers or some kind of biometric identity to be used to make it difficult for stolen cards to be made use of.

Fraud is one major issue which has been faced by Medicare and while policymakers continue to look for a solution, nothing so far has been come up with. Despite efforts being made by the CMS to combat fraud, improper Medicare payments have increase greatly with the report by GAO suggesting that the federal government managed to make around $60 billion in 2014 with respect to such payments which is an increase of $48 billion from 2010. The second significant contributor towards improper Medicare payments in 2014 was earned income tax credit which was of a value of $18 billion. While it is not possible to estimate what proportion of these payments may be attributable to each Medicare fraud type, it can thus not be determined exactly how much savings will be with regard to electronic cards being implemented. This is because such cards can only protect against special types of fraud and do not have the likelihood of impacting frauds which are in no way associated with authentication.
CMS would then have to update claims regarding technology and the mechanisms used for the management of cards to be able to take complete advantage of electronic cards which could however lead to problems for an agency which hasn’t been known for making use of the best technology system there is. GAO too has been critical of the system used by CMS and the latter too has admitted the need for their technology to be more updated but has been slow in bringing about the needed change.

There have been 3 types of Medicare electronic cards which have been suggested which include the magnetic stripe card, the bar code cards and the smart card which contains micro-processor chips. All of these can be used for the storage of information as well as for authentication however the GAO finds the bar code and the magnetic strip cards as being the least effective as these are the ones greatly at risk for counterfeit. Smart cards however according to GAO are more secure and effective.

To prevent fraud from occurring, quality of care can be improved with the use of electronic cards which can facilitate the exchange between the beneficiary and provider in an electronic manner. Health records could also be stored and shared through these cards along with providing additional health related information about the patient. This would also allow better record keeping as every piece of information would be included electronically.


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