Watchdog Agency: Improper Use of Medicare Data Rampant

The Department of Health and Human Services Office of Inspector General on Friday released findings of an audit it conducted at the request of the Centers of Medicare and Medicaid Services that looked into how a mail order pharmacy and other healthcare providers were misusing a type of electronic transaction meant to verify Medicare beneficiaries’ eligibility for certain coverage benefits.

HHS OIG confirmed to Information Security Media Group that the findings from that smaller scale audit prompted the launch of a more expansive nationwide investigation into whether Medicare beneficiary information is being inappropriately obtained through these electronic Eligibility Verification Transactions, also known as or E1 transactions, violating patients’ privacy.

“The report that came out today was more narrow in scope, [but] the nationwide audit to be announced next week will aim to determine how widespread the inappropriate use of these transactions is,” an HHS OIG spokeswoman tells ISMG.