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health insurance

Lawmakers’ Social Security numbers, home address stolen in DC Health Link data breach
Illustration of a stethoscope draped over the dome of the US Capitol building.

Illustration: Gabriella Turrisi/Axios

A hacker who uses the pseudonym “Denfur” is selling a database they claim includes stolen sensitive data from at least 55,000 customers of D.C.’s health insurance marketplace, including members of Congress and their staffs.

Driving the news: Congressional leaders started warning lawmakers on Wednesday about the breach at DC Health Link and suggested they freeze their credit while an investigation continues.

  • DC Health Link, which confirmed the breach and dark web leaks in a statement, helps all city residents purchase health insurance, not just members of Congress.

What’s happening: Researchers at Check Point Research told Axios Thursday that a malicious hacker had posted the database for sale on the “biggest English-speaking dark web hacking forum.” The member claims the database includes sensitive data from thousands of customers, including Social Security numbers, birthdates and home addresses.

  • Denfur is now selling the stolen database for just “a few dollars,” researchers noted. Denfur signed off the post with “Glory to Russia!”
  • CyberScoop reports that a sample of the stolen data includes information about former defense officials and lobbyists, and the Associated Press reported it was able to authenticate data belonging to two victims in the set.
  • Axios has seen the dark web post, which was still live as of Friday morning.

Why it matters: Malicious actors often rely on stolen personal data to commit identity theft and hijack online accounts, and it’s rare for them to be able to collect verifiable information from high-ranking U.S. officials.

What they’re saying: “Such precious information will have high demand in the dark web and, in the wrong hands, can lead to significant downstream consequences,” Sergey Shykevich, threat intelligence manager at Check Point Research, said in a statement.

Zoom out: The breach comes as lawmakers focus more on cybersecurity issues plaguing the health care

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April 11, 2023 by INSURANCE

Hennen: Don’t limit options for affordable health insurance – InForum

In my world, I regularly hear about how to keep health care affordable, especially health insurance. My audience talks about it. Families struggling to make ends meet talk about it, too. That’s why a bill being considered in the North Dakota Legislature, HB 1416, caught my interest.

The verbiage from the bill says it’s “a bill relating to freedom of choice for health care services.” And it was repeated: “Be it enacted by the legislative assembly of North Dakota… freedom of choice for health care services.” That’s the fancy description. For me, it’s exactly the opposite. It’s removing a choice that allows consumers to save money on health insurance. That is a bad idea.

HB 1416 would allow any health care provider to join an insurance company’s narrow network, which is an important health insurance option for cost-conscious consumers who choose to see fewer providers but pay a significantly lower monthly bill.

Proponents — who have peddled their opinions on the editorial pages — have claimed this legislation will provide “freedom of choice for health care services,” allowing patients more choice when selecting their health care providers. That’s just wrong. In reality, patients already make that choice when they select their health insurance plan. What HB 1416 does is the opposite of choice; it eliminates an affordable health insurance option.

Health insurance companies use different networks, or groups of health care providers, to give consumers options. A broad network plan consists of nearly all providers within a service area. These plans are more expensive. A narrow network plan, however, consists of fewer providers who have agreed to a reduced contracted rate in exchange for an anticipated increase in patient volume. These plans are about 20% more affordable than broad network plans. Yes, 20%!

Take our company, Flag Family Media, as

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April 6, 2023 by INSURANCE

Christine Cupitt wants to reframe the life insurance sector as Council of Australian Life Insurers chief

Life insurers also took “important steps” during the pandemic that were “worth revisiting”, Mr Cupitt said, pointing to commitments that COVID-19 vaccines would not affect policy terms and conditions.

But she admitted the story of life insurance’s social role had not been well-articulated in the past – a common complaint among the industry executives who led the establishment of a standalone lobby group.

She said the sector had been focused on complying with a raft of new rules and regulations, after the royal commission made 15 recommendations relating to insurance, including a ban on so-called “hawking” of insurance products and reclassification of “claims handling” as a financial service.

It had also been distracted by significant consolidation, including TAL’s acquisition of Westpac’s BT Life business and Zurich’s purchase of ANZ’s OnePath life insurance business as the major banks quit the sector.

Recruitment drive

“We’ve now got to a point where those regulatory reforms are embedded, the code [of conduct] is being implemented, a lot of M&A activity has settled down,” she said. “We have the opportunity now to work with a new government to explain the role and value of life insurance.”

To achieve that, the CALI board – co-chaired by TAL chief Brett Clark and AIA Australia chief Damien Mu – has been on a spending spree, recruiting Ms Cupitt last year and Keely O’Brien, a former adviser to former prime minister Julia Gillard, as general manager of corporate affairs.

The Australian Financial Review has confirmed former Westpac head of government affairs Michael Johnston and Financial Planning Association policy chief Ben Marshan are also joining CALI in key roles.

Ms Cupitt said her priority was to make sure Australians had sufficient insurance cover in place, after research suggested this was not the case.

She said she wanted to

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March 29, 2023 by INSURANCE

Hundreds of thousands may lose Medicaid health insurance as rules change for renewal

HARRISBURG, Pa. (KDKA) – Over 3 million Pennsylvanians on Medicaid will have to reapply for continued coverage beginning April 1.

During the pandemic, those on Medicaid, state-provided health insurance for lower-income Pennsylvanians, did not have to reapply each year to determine their eligibility, but the federal government is ending that.

“Beginning April 1, when your annual renewal is up for your Medicaid insurance, you’ll be sent information to share information with us to see if you’re still eligible to receive Medicaid, and if you are, no problem, you’ll be continued,” said Department of Human Services Acting Secretary Val Arkoosh.

Arkoosh believes hundreds of thousands of Pennsylvanians could lose their health insurance.

“Probably around 620,000 may be making too much money now to qualify for Medicaid,” Arkoosh said.

Arkoosh hopes many of those now have jobs with employer-provided insurance, but, if not, she encourages people to contact Pennie, the state’s health insurance marketplace under the Affordable Care Act.

“We will hand them off to Pennie where people can get very good, very high quality plans at a very low cost in the Pennsylvania marketplace,” Arkoosh said.

Even if the parents are no longer eligible for Medicaid, their children might still qualify under CHIP, the Children’s Health Insurance Program.

“Every child in the commonwealth, no matter what their parent makes, is eligible to get a health insurance policy through the CHIP program. What differs is how much they’ll pay for that health insurance policy,” Arkoosh said.

Arkoosh says the income eligibility for Medicaid has not changed. If you’re single and earn less than $20,120, you’re still eligible. For a family of four, if your income is below $41,400, you’re eligible for this free medical insurance, but you must submit your renewal forms when received.

If you don’t respond or ignore the deadlines,

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March 21, 2023 by INSURANCE

US House of Representatives impacted by health insurance data breach

Sensitive information for members of Congress and their staff and family members has been exposed in a data breach, according to House leaders. The was able to purchase leaked information from health insurance marketplace DC Health Link on the dark web, House Speaker Kevin McCarthy and House Minority Leader Hakeem Jeffries wrote in .

The data included the names of enrollees’ spouses, dependent children, social security numbers and home addresses, according to the letter. “This breach significantly increase the risk that members, staff and their families will experience identity theft, financial crimes and physical threats — already an ongoing concern,” it reads.

McCarthy and Jeffires said the FBI hadn’t yet determined the size and scope of the breach, though they indicated that the impact on “House customers could be extraordinary.” They noted that thousands of House members and employees from throughout the country have signed up for health insurance through DC Health Link since 2014.

“Fortunately, the individuals selling the information appear unaware of the high-level sensitivity of the confidential information in their possession, and its relation to Members of Congress,” the House leaders wrote. “This will certainly change as media reports more widely publicize the breach.”

“Currently, I do not know the size and scope of the breach, but have been informed by the Federal Bureau of Investigation (FBI) that account information and [personally identifiable information] of hundreds of Members and House staff were stolen,” Catherine L. Szpindor, the House of Representatives’ chief administrative officer, wrote in a letter to colleagues. Reports that the data also includes details on senators and their staff, but that information was seemingly limited to their names and those of family members.

DC Health Link operator DC Health Benefit Exchange Authority said it has opened an investigation. “We are in the process of

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March 12, 2023 by INSURANCE

MassHealth members may soon lose health insurance. Here’s what to expect in the mail.

If you have insurance through MassHealth, be on the lookout in the coming months for a blue envelope in your mail.

Hundreds of thousands of people are expected to be booted off the state-run health insurance program over the next year as federal continuous coverage requirements for Medicaid in place since March 2020 expire and the state goes through the required redetermination process for the first time since the pandemic start. The Healey administration expects that MassHealth membership will fall from its current level of more than 2.3 million people to about 1.9 million people over the next year, freeing up $1.9 billion in fiscal year 2024 state spending.

Mike Levine, MassHealth assistant secretary, said Thursday that an estimated 50 percent of MassHealth members can be automatically renewed. Those members will receive a letter in the mail telling them that their eligibility has been renewed and that no action is needed of them.

“For the subset of members where we cannot automatically process their renewal, we are going to be sending a blue envelope that hopefully is hard to miss,” Levine said. “That will include a form with all the information we need from them that they need to return to us. They can send it back via the mail, they can call us, they can go online, there are many, many channels that members have to get MassHealth the information we need. But we want to make it as clear and bold and visible for members as possible that there’s this blue envelope that indicates that you need to take action.”

But because it’s been three years since failure to respond to a letter from MassHealth has put members at risk of losing their coverage, Levine said MassHealth has already begun reaching out to members “to make sure people

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March 10, 2023 by INSURANCE

Insurance capital can’t figure out health insurance

Like a lot of people in middle age, I have some health issues that occasionally require seeing a specialist. The “good” aspect of my insurance is that those visits are covered.

But it’s not that simple, because nothing is ever that simple.

Getting coverage to see a specialist means I need preapproval from my primary care doctor, despite having never met my primary care doctor. What it really means is someone in the office has to check a box on an electronic form.

It’s not even required in advance. The preapproval can be postdated. All that’s required is that the box be checked by someone, at some point.

Sometimes that step gets missed, at which time I’m charged for visiting the specialist. News that I owe money to my provider arrives somewhere in the blizzard of correspondence that comes to a family of four, each of whom is receiving care at some level, the vast majority of which says “This Is Not A Bill,” which at some point means you stop paying attention.

Anyway, if someone forgets to check the box, I get charged, and if I miss the bill, it goes to a collection agency, which has happened twice in the past year. Suddenly I’m having to explain to some chatbots that I really don’t owe $495, and that my doctor’s office knows that I don’t owe the money, but it requires all kinds of back and forth and long phone calls to get it sorted out.

This is, as mentioned, good insurance. Many people are in a far more prestigious position. It’s hard not to think we could do better.

Maybe, for example, we could have insurance that covers people’s health needs but doesn’t put a private company’s profits as its top priority? It sounds crazy, but

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February 7, 2023 by INSURANCE

Feds expect to collect $4.7B in insurance fraud penalties

AMANDA SEITZ Associated Press

WASHINGTON — The Biden administration estimates that it could collect as much as $4.7 billion from insurance companies with newer and tougher penalties for submitting improper charges on the taxpayers’ tab for Medicare Advantage care.

Federal watchdogs have been sounding the alarm for years about questionable charges on the government‘s private version of the Medicare program, with investigators raising the possibility that insurance companies could be bilking taxpayers of billions of dollars each year by claiming members are sicker than they really are to receive inflated payments.

The Department of Health and Human Services said it will begin collecting payments from insurers when an audit turns up that they are charged for diagnoses that are not reflected in the patient’s medical records. The government has not sought refunds for those payments in more than a decade, the agency said.

People are also reading…

“Today, we are taking some long overdue steps to move us in the direction of accountability,” HHS Secretary Xavier Becerra said Monday.

The penalties are expected to return $4.7 billion over the next decade, the agency estimated.

The questionable payments are submitted through Medicare Advantage, a booming program that nearly half of the 60 million people enrolled in Medicare signed up for. Medicare Advantage is different from traditional Medicare, with private companies offering plans that are reimbursed by the government for care. The government spent $900 billion last year overall on Medicare.

With the rise in popularity has come growing concern that insurers are ripping off taxpayers by overstating how sick a patient is to unlock higher reimbursement from the government. The HHS Office of the Inspector General raised red flags about $6.7 billion worth of payments for patients whose diagnoses were not supported by medical records in 2017, for example.

Insurers

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February 4, 2023 by INSURANCE

300,000 Oregonians at risk of losing state health insurance. Here’s why.

An estimated 300,000 Oregonians could lose state health insurance in the next 16 months because they no longer qualify for state coverage made more widely available during the COVID-19 pandemic.

All approximately 1.5 million people receiving coverage through the state will soon need to be financially eligible for the program to keep their state health insurance, following a three-year federal reprieve from normal requirements due to the pandemic.

That reprieve is soon coming to an end, giving state officials just over a year to make sure everyone who qualifies for coverage keeps it.

“Our real goal is to make sure that we preserve all the benefits that we can,” interim Oregon Health Authority director James Schroeder said in a presentation to lawmakers Tuesday. “But at the end of the day, people are either going to be eligible or not.”

Under federal rules put in place soon after the pandemic started, Oregonians did not have to prove financial hardship or work status in order to qualify for Medicaid coverage, which in Oregon is called the Oregon Health Plan. Coverage expanded dramatically in the last three years, from about 1,080,000 Oregonians before the pandemic to about 1,470,000 today, according to state data.

But on April 1, Oregon will start a 14-month process to verify that people do not make too much money to qualify for the low-income health insurance program and meet other requirements. The state will follow up with those who no longer qualify to help them transition to coverage through the health insurance marketplace, officials said.

The Oregon Department of Human Services, which is responsible for checking eligibility for its own programs and for the health authority, called the volume of work ahead “historic.”

“We are serving the highest caseload we’ve ever had in the history of our

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January 28, 2023 by INSURANCE

Do I Need Travel Insurance For My 2023 Vacation?

Mark Graham is planning a trip to Sicily and France with his wife this summer. He’s still working out some of the details, but one thing he is sure of: getting travel insurance. Graham can’t imagine traveling without it.

“We feel better knowing we have the safety of insurance,” says Graham, a retired telecommunications worker from Danville, Calif.

And who can blame him? The pandemic made travel insurance a must-have item for many travelers, including people like Graham, who fit the “must be insured” profile (retired, overseas travel, cruising). Others who are planning their 2023 trips may still be on the fence. I can help you decide.

It’s going to be another interesting year for travel, experts say.

“Between flight disruptions, weather issues, and unexpected medical emergencies, travel is unpredictable and will continue to be so in 2023,” says Carol Mueller, a vice president at Berkshire Hathaway Travel Protection.

It’s natural for people to think about travel insurance. But what should they do? Graham’s concerns are common. For example, what if there’s another COVID outbreak or the war in Ukraine affected his cruise? He’s also worried about a possible trip disruption or medical emergency. Those are issues that a standard travel insurance policy can address. But there are so many choices.

“Travelers are more interested in purchasing travel insurance than ever,” said Karisa Cernera, a director at Redpoint Travel Protection, a travel insurance company. “But choosing a travel protection plan can be overwhelming.”

What kind of insurance is available for your 2023 trip?

If you’re planning

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January 10, 2023 by INSURANCE
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