The Centers for Medicare & Medicaid Services (CMS) has launched the IDea Challenge to fight fraud related to health plan identifiers (IDs) and to enhance ID security.
In a Sept. 8 news announcement, CMS said it would host two in-person events in San Francisco, California (Nov. 5) and New York City (Nov. 13) that “will bring together experts from diverse backgrounds to develop innovative ways to protect patient information.”
The agency is inviting experts in a number of fields — including health care, payment processing, cybersecurity, clearinghouses, program integrity, and Medicare beneficiary-centered organizations — to declare their interest in attending either event by submitting an “interest form” by Sept. 26.
“Health plans use confidential member IDs for transactions like health-care billing, eligibility status and claim status,” the announcement said. “Individuals committing health-care fraud are increasingly stealing Medicare Beneficiary Identifiers (MBIs) and other member IDs in various ways, such as deceiving patients, hacking into health-care organizations’ systems, or misusing online lookup tools. Once member IDs are stolen, they are used to submit fraudulent claims to Medicare and other health insurance companies. This leads to financial losses and reduces trust in the health-care system.”
IDea Challenge participants will “offer varied perspectives to better protect patient information” and will “spend a full day working in small teams of diverse professional backgrounds to develop ideas to improve member ID security perspectives.” The teams will then pitch their ideas to CMS at the end of the day.
This latest call for volunteers to develop and pitch ideas to CMS follows the August announcement of the CMS Crushing Fraud Chili Cook-Off, “aimed at harnessing explainable artificial intelligence, specifically machine learning models, to detect anomalies and trend in Medicare claims data that can be translated into novel indicators of fraud.”
