U.S. Medicaid – how can we protect the most vulnerable?

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The Subcommittee on Health, under the Energy & Commerce Committee is holding ongoing hearings as part of an examination of how to reform Medicaid. These hearings focus on creating more universal, federally mandated rules and requirements for Medicaid that hope to strengthen the largest government health care program. An important part of reform centers on fraud reduction and securing Medicaid beneficiaries from identity theft.

Currently very few providers of Medicaid care require any strong evidence of patient identity, and often it boils down to only a verbal confirmation of identity and coverage.  This lack of identification is at the root of Medicaid fraud and could be stopped with the implementation of stronger security measures.

Current Medicaid cards are paper or plastic and lack any advanced security features.  Replacing them with a “smart card” is the preferred tried and tested solution that could support the capabilities needed to address the identity theft and fraud. A smart card is a highly secure card which contains a secure chip to store identity information. Smart card technology has become the standard for securing privacy all over the world.  Because of the security benefits, these chips are already used in U.S. passports, credit cards, secure banking, and employee access badges.

If the Medicaid program were to adopt a smart card, patients’ identity information would be tamper proof.  When used in conjunction with a PIN number, like a debit card, the system could verify that entitled patient and only the patient could receive the high quality care that they deserve.

For added fraud reduction, I would suggest that we equip healthcare providers themselves, in addition to patients, with a smart card to properly verify their identification information. The combination of both the patient and provider using the advanced cryptography supported by smart cards ensures that the patient  is not only a part of the Medicaid program, but that the provider is in fact a licensed physician or provider and not a criminal or phantom provider.

Medicaid is designed to be a government insurance program for people of all ages whose income and resources do not cover sufficient health care. This program will continue to provide aid only while the funds from the state and federal governments remain available, which makes it even more important to stop the fraud that has plagued this program. Smart cards are a reliable solution that could provide Medicaid with a shield against theft and fraud ensuring the protection of the most vulnerable for many years to come.

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