I recently wrote about a Tucson senior whose Social Security record was incorrectly changed to “deceased”.  This man has talked to Social Security on the phone, met with them in person at the local office, and been assured that his record has been corrected.  That was more than a month ago, but Medicare still has him as dead.

An aide from Gabrielle Gifford’s office talked to Social Security this week - but it’s Medicare that has the problem.

Wednesday, I was on a conference call with the Medicare Administrator who was talking to the press about the end-of-year deadline for Medicare beneficiaries to change their Part D and Medicare Advantage plans.  As a blogger focused Medicare I get invitations to Medicare administration conference calls with “the press”.

When it came time for questions, I decided I might as well ask the top guy at Medicare if he could fix the Tucson senior’s problem. Dr. Berwick, the boss at Medicare, asked for my phone number so he could follow up with me to see if this problem gets fixed, and one of his assistants asked me to get the details to him so he could get it fixed.

So we’ll see how long it takes to fix a Medicare problem when the top guy says “get it done!”.  I’ll report on the outcome.

I met with a man who recently lost his wife to a long illness. He was still getting over his loss when he received a letter from his credit card company informing him that his card had been canceled.  He called the credit card company and was told his account had been closed because he was dead.

It seems Social Security made a mistake when his wife died and instead put into his record that he was deceased.  This information probably goes to credit reporting agencies and was picked up by his credit card company.  He told the company he was alive and well and would like to pay his last bill, which had been held by the company.  The company would not send him the bill so he could pay it because, according to their records, he was deceased.

This man called Social Security and pointed out their error.  He was told his record would  be corrected. That was three weeks ago.

This man has a Medicare Advantage plan that is being canceled and he needs to enroll in another plan, so I submitted an application for him to the AARP Medicare Complete Plus plan by UnitedHealthcare.  I checked the next day on my computer to see that his application had been received and I saw the notation, “Denied due to death”.

I’ve decided to mention the name of the company because I know they read everything that is written about them, and I mght need some help from higher up to fix this problem.

Medicare Advantage companies check the Medicare record of each applicant to make sure the information on the application is correct before they send the file to Medicare.  Medicare had gotten the report of this man’s death from Social Security, but two weeks after Social Security corrected his record, Medicare had not received the correction.

This should be an interesting case to see how two large government bureaucracies work. And UnitedHealthcare is so large that I have often said it is like the government.  We’ll see how this turns out. And hopefully it gets resolved soon because this man only has until the end of December to get enrolled in a new Medicare Advantage plan. If he misses that deadline there will be another bureaucratic mess to deal with.

The government stepped up the fight against Medicare fraud in 2009 with 77 people going to prison and $2.5 billion recovered for the Medicare Trust fund.  The U.S. Department of Health and Human Services (HHS) announced these results and described expanded efforts to fight fraud in the Medicare system.

Medicare Fraud Strike Force teams, which are joint operations between the Department of Justice, Health and Human Services and state and local partners, have been expanded to seven communities with high levels of health care fraud: South Florida; Los Angeles; Houston; Detroit; Brooklyn, N.Y.; and Baton Rouge, La.

During Fiscal Year (FY) 2009, the federal government won or negotiated approximately $1.63 billion in judgments and settlements according to HHS.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established a national Health Care Fraud and Abuse Control Program (HCFAC) which was charged with investigating and prosecuting Medicare fraud.  According to HHS, some of their recent accomplishments include:

• Deposits to the Medicare Trust Fund totaled approximately $2.51 billion in FY 2009 as a result of these efforts, a $569 million, or 29 percent, increase over FY 2008.
• In addition, more than $441 million in federal Medicaid money was transferred separately to the U.S. Treasury – 28 percent more than in FY 2008.
• The HCFAC account has returned more than $15.6 billion to the Medicare Trust Fund since its inception in 1997.  During the past 3 years (2006-2009), the return-on-investment from the HCFAC law enforcement activities that form the primary focus of this annual report has averaged approximately $4 returned to the Trust Fund for every $1 of HCFAC funding provided for enforcement activities.

I wonder why there has been such an increase in the fight against Medicare fraud.  Perhaps it’s because somebody in government actually cares about this issue – finally.