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The following article was published in our article directory on July 31, 2014.
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health management systems give private info to overseas outsourcers

Article Category: Business Management

Author Name: James M. Odato

Confidential information regarding hundreds of thousands of New York healthcare patients might have been shared with foreign nationals this year due to a now-contentious contract between the Office of Medicaid Inspector General and a principal vendor, according to two people associated with the case.

OMIG has a $155 million contract with a service provider called Health Management Systems (HMS) to evaluate if people have a primary insurance company to bill other than Medicaid. These "third party insurance verifications" assist New York lessen the burden on the $57 billion Medicaid program for patients who require publicly sponsored medical insurance coverage.

As explained by individuals familiar with the matter, OMIG's third-party tracker, Health Management Systems, has subcontracted work with an additional service provider, Datamatics, which in turn has business abroad. An ancillary office in Chennai, India, has actually taken on many of the duties, according to a person involved.

The work requires making use of patients' information to discover if they possess insurance coverage that ought to be utilized before Medicaid is considered. The third-party tracking is among OMIG's best ways to prevent unnecessary billings to Medicaid.

Under an agreement entered into at an earlier time this year by Health Management Systems, foreign nationals may access the name, address, Social security number, dates of birth and insurance providers associated with people in New York's database, according to individuals involved in the matter. The expense when employees in Texas carried out the third-party work was roughly $1.25 per beneficiary. The cost for the Indian firm is roughly 15 cents per beneficiary, an individual associated with the process stated, adding that hundreds of jobs at HMS have been cut because of the outsourcing.

The Times Union queried OMIG representatives about the outsourcing in late May, and the agency promised to tackle the issue. As of Friday, OMIG representatives were unwilling to discuss exactly what is being done, even though HMS and OMIG are definitely now up in arms over the subcontracting, according to a person involved.

Wanda Fischer, an OMIG spokeswoman, stated her office works with HMS "but does not have a relationship with Datamatics.".

"OMIG takes the security of personal data very seriously," she stated. "OMIG is investigating the matter.".

Fischer's boss, Deputy Medicaid Inspector General Mark Hennessey, added: "OMIG works to ensure the security of personal data. As this is an ongoing investigation, we can not comment on the matter.".

Francesca Marraro, an HMS spokesperson, said the data used to help New York discover third-party insurance providers is actually "physically located" on secure systems in the United States. She said she did not know if vendors in other countries are able to access it.

"We obviously comply with all federal and state laws," she stated. "All the work we do-- all the information we provide-- is located here in the United States.".

Keywords: {health management systems|health management system}

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