Newspaper article St Louis Post-Dispatch (MO)

Health-Care Fraud Forces New Identification System

Newspaper article St Louis Post-Dispatch (MO)

Health-Care Fraud Forces New Identification System

Article excerpt

MILLIONS OF DOCTORS, hospitals, health insurers and players in the medical field will be issued a new I.D. number starting next year as part of a government effort to fight fraud and to simplify payments.

Prosecutors say the new system will help them track down dishonest health-care providers who use multiple identification numbers to hide from authorities.

But civil libertarians warn that the new "National Provider Identifier" and a related code for health insurance plans are the first major steps toward Big Brother's takeover of previously private information of doctors and their patients. A patient identifier is coming next, they say. "This is an essential building block in creating an overall scheme to destroy the privacy of patient records," said Donald Haines, a lobbyist for the American Civil Liberties Union in Washington. Requirements for national identifier numbers were included in the health-care bill that Congress passed and President Bill Clinton signed last summer. The Health Care Financing Administration now says it will seek public comment in February on the new identifying number. The government plans to begin requiring use of the National Provider Identifier by the roughly 1.25 million health-care providers who bill Medicare: doctors, hospitals, nursing homes, dentists and laboratories. The identifier likely will be a combination of eight numbers and letters, according to Stewart Streimer, an official involved in the project. In addition to the code for providers, Streimer said the Health Care Financing Administration was assigning a nine-digit identifier to about 4 million health-care "payers": HMOs, private insurers and employee benefit plans. The government agency hopes to begin issuing the payer identifier early in 1998. As it stands now, doctors and other providers use different identification codes and numbers for different programs. Medicare assigns one identifier, and Medicaid assigns another. Private insurers might assign a third. To further confuse the matter, doctors have one type of identification number and hospitals have another type. Along with creating frustration and confusion for everyone, the current system helps dishonest operators defraud health-care insurers and the government. Deceptive doctors and other providers register under multiple identification numbers so that, when they are caught defrauding the government, they begin billing Medicare under a new number. …

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