The Senior Citizens League (TSCL) Monthly Washington Update for the end of February 2024

At the end of this first week of March, it's time to look back at what happened in February about issues that concern or have affected seniors in our nation. The first two issues you should know about involve possible scams affecting seniors.

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Near the end of February, headlines throughout the country announced this:

'Nation-State' Cyberattack Hits Change Healthcare, Disrupting Pharmacy Services Across the Country

Pharmacies across the country are facing disruptions following a cyberattack on Change Healthcare — which is owned by Optum, a subsidiary of UnitedHealth Group. In a filing with the SEC, UnitedHealth stated that the unauthorized party that gained access to Change Healthcare's systems was a "suspected nation-state associated cyber security threat actor."

The article that followed that headline said this:

Pharmacy chains across the country are facing disruptions due to a cyberattack on Change Healthcare, a Nashville-based company that processes patient payments for healthcare organizations.

Change Healthcare is owned by Optum, a subsidiary of insurance giant UnitedHealth Group. On its website, Change Healthcare says that it manages 15 billion transactions per year and is the country's largest commercial prescription processor. 

Since then, the situation has blossomed into a crisis. The impact has widened, and it is expected to grow.

The American Hospital Association has said many of its members aren't getting paid, and doctors can't check whether patients have coverage for care.

Because of this attack, some patients may have been or may be routed to new pharmacies that are less affected by billing problems. Industry executives said that patients' bills may also be delayed. At some point, many patients will likely receive notices that their data was breached. Those patients may be at risk for identity theft depending on the exact data pilfered. Companies often offer free credit monitoring services in those situations.

Healthcare providers and organizations are now asking the federal government for help as the fallout from the cyberattack.

The American Hospital Association has written a letter asking congressional leaders for assistance, including having the Centers for Medicare and Medicaid Services (CMS) begin to advance payments to providers to lessen the financial burden they face.

In addition, Senate Majority Leader Chuck Schumer (D-N.Y.) is urging CMS to immediately make Accelerated and Advanced Payments available to the hospitals, pharmacies, and relevant providers affected by the cyberattack.

TSCL will continue to monitor this situation and pass along any information that might be important to you.

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Government Says Scammers are Targeting Seniors

The U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) is alerting the public about a fraud scheme involving Durable Medical Equipment (DME), specifically urinary catheters.

Scammers target Medicare enrollees through phone calls, internet ads, and text messages, offering free services, medical equipment, or gift cards upon confirming their personal information and eligibility for specific Medicare services.

Often, the enticement for the individual is that they are "qualified" for items "at no cost" or "free." Once the scammers obtain the enrollee's personal information, monthly billing to Medicare will begin for medically unnecessary urinary catheters that may or may not be sent to the enrollee.

Typically, the scheme begins with a contact from an unscrupulous Durable Medical Equipment (DME) company claiming they work for Medicare or are calling on behalf of Medicare. Their goal is to obtain the enrollee's Medicare number.

Protect Yourself

• If you receive a call from someone offering you free urinary catheters or other Durable Medical Equipment and services that will be billed to Medicare, hang up immediately.
• Be suspicious of anyone who offers you free medical equipment and then requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes.
• If medical equipment is delivered to you, don't accept it unless your physician ordered it. Refuse the delivery or return it to the sender. Keep a record of the sender's name and the date you returned the items.
• Review any Explanation of Benefits documents you receive. Scan for any supplies you did not order.
• Medicare enrollees should be cautious of unsolicited requests for Medicare numbers. No one other than your provider's office should ever request your Medicare information. There is no other circumstance when providing it is appropriate or safe.
• If you suspect Medicare fraud, report it immediately online or call the HHS-OIG Hotline at 1-800-HHS-TIPS (1-800-447-8477).

In addition, Medicare has put out this information to help protect you from all Medicare scams or fraud:

1. If you get a call, text, or email asking for your Medicare Number, don't respond. Don't give your Medicare card or Medicare Number to anyone except your doctor or people you know who should have it.
2. Check your Medicare Summary Notices (MSNs) or claims statements carefully. If you see a charge for a service you didn't get or a product you didn't order, it may be fraud. If you suspect fraud, report it to 1-800-MEDICARE (1-800-633-4227).
3. Guard your Medicare card like it's a credit card.

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President Launches Task Force to Stop Illegal Price Hikes

The Biden Administration has launched the Strike Force on Unfair and Illegal Pricing, co-chaired by the Department of Justice and the Federal Trade Commission.

According to the White House, the new task force "will strengthen interagency efforts to root out and stop illegal corporate behavior that hikes prices on American families through anti-competitive, unfair, deceptive, or fraudulent business practices" in multiple sectors — including prescription drugs and health care.

Other task force targets include groceries, financial services, and so-called "junk fees."

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House Manages to Pass Bill to Fund Part of Government for Rest of the Fiscal Year

Although this news is occurring now and not in February, it's important, so we want you to know about it.

Legislation crucial to hospitals, physicians, and community health centers took a major step forward this week when the House passed a measure to prevent parts of the federal government from shutting down. The bill would delay an $8 billion reduction in Medicaid disproportionate share hospital payments for a year, alleviate a Medicare physician pay cut that took effect Jan. 1, and extend funding for federally qualified health centers for four years.

As we have seen for the past year and a half, the House of Representatives has been the part of government that is most unruly and in disarray, which has resulted in the inability to pass very little in the way of legislation.

So, the passage of this bill is significant. The Senate will still have to deal with it, and then both houses will have to get together and deal with the differences in each bill so they can produce a single bill that can be sent to the President for his signature.

However, even if that all happens, this bill only deals with part of the federal government. Additional legislation will have to be passed soon to avoid a partial government shutdown in the near future.

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Nursing Homes Struggle With Staffing – Must Turn Away Residents

According to a report released by the industry trade group released Tuesday, nearly half of nursing homes polled by the American Health Care Association are limiting admissions due to severe staffing shortages. In a survey conducted last month of 441 nursing homes across the country, seven out of ten operators reported lower staffing levels than before the COVID-19 pandemic.

The following are some of the results of the survey:

• Forty-six percent of nursing homes have limited new admissions, with 38 percent turning away residents weekly and/or monthly, and seven percent turning away residents daily.
• Nearly 20 percent have closed a unit, wing, or floor because of labor challenges.
• Sixty-six percent of facilities are concerned that if their workforce challenges persist, they may have to close their facility.
• Ninety-nine percent of nursing homes currently have open jobs, including 89 percent who are actively trying to hire for registered nurse (RN) positions. 
• Seventy-two percent of nursing homes say their current workforce levels are lower than pre-pandemic staffing levels.
• More than half of nursing homes say their workforce situation has changed or worsened.

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