Fraud Fears: Real or Not?

Sep 19, 2013

Florida Gov. Rick Scott, one of the most vocal critics of the Affordable Care Act, has spent the past month raising alarms that signing up for a health plan will put citizens' privacy  at risk.

He has managed to attract a lot of media attention, and the White House's effort to combat the rhetoric with explanations of the data hub security system -- a complex subject -- has been pretty much ignored.

So on Wednesday, as Kaiser Health News reports, senior Obama administration officials tried a different tack: They said yes, there is a danger of fraud, but not the one that Scott and other Republican governors are talking about.

"Don't be a victim of consumer fraud in the health insurance marketplace," says an alert from the Office of Inspector General in the Department of Health and Human Services.  The alert says to beware of "people  asking for money to enroll you in Marketplace or 'Obamacare' insurance" and "high-pressure visits, mail solicitations, e-mails and phone calls from people to work for the government," among other things.

In a podcast, OIG investigator Jennifer Trussell offers examples of what to watch out for. She tells those who suspect fraud to call the Health Insurance Marketplace consumer call center at 1-800-318-2596.

Congress picked up the refrain from Scott and other anti-Obamacare governors, holding hearings that featured two lawmakers from Florida, as Health News Florida reported.

In Florida, the Department of Health has said "navigators" -- enrollment advisors for the federal online Marketplace -- may not work in their offices in county health departments, as Health News Florida reported. Instead, consumers who need help may get it from agencies that have navigator grants and from certain health-care providers, including many hospitals and pharmacies.

In Florida, navigators must go through a 3-step process: passing a federal test after online training; being fingerprinted by an approved state of Florida vendor; and getting a license from the state Division of Financial Services, which has an information site.

Navigators will have no need to collect medical records or ask questions about patients' health, since a health condition will no longer be a bar to enrollment in a plan after Jan. 1 under the Affordable Care Act.

Scott has said he is concerned about the information -- Social Security number, income -- that could be used for identity theft. Others point out that Florida already sponsors programs in which Floridians sign up for benefits.

Examples include Florida KidCare and Florida SHINE (Serving Health Insurance Needs of Elders) program, who help Medicare beneficiaries enroll in health and prescription drug plans each fall.