Monday, April 8, 2013

Fwd: qotd: Dependent verification programs. What a crime!

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-------- Original Message --------
Subject: qotd: Dependent verification programs. What a crime!
Date: Mon, 8 Apr 2013 05:12:51 -0700
From: Don McCanne <>
To: Quote-of-the-Day <>

The National Bureau of Economic Research (NBER)
April 2013
Fraud in the Workplace? Evidence from a Dependent Verification Program
By Michael Geruso, Harvey S. Rosen

Many employers have implemented dependent verification (DV) programs,
which aim to reduce employee benefits costs by ensuring that ineligible
persons are not enrolled in their health plan as dependents. We evaluate
a DV program using a panel of health plan enrollment data from a large,
single-site employer. We find that dependents were 2.7 percentage points
less likely to be reenrolled in the year that DV was introduced,
indicating that this fraction of dependents was ineligibly enrolled
prior to the program's introduction. We show that these dependents were
actually ineligible, rather than merely discouraged from re-enrollment
by compliance costs.


Blue Cross Blue Shield of Hawaii
Hawaii Medical Service Association
Help Prevent Health Plan Enrollment Fraud

Health plan enrollment fraud occurs when a person or company
intentionally misrepresents facts to improperly receive health care
products and services. This includes adding a person who is not eligible
for health plan coverage as a dependent on a health plan.

It is a criminal offense under state and federal laws to fraudulently
enroll someone onto a health plan. Enrolling ineligible dependents can
lead to increased health care costs for employers. Penalties include
fines, immediate loss of health plan coverage, or imprisonment.


Dependent Eligibility Verification Project

The initial phase of the DEV project includes an amnesty period that
runs from now through June 30, 2013. If you have one or more dependents
on your health plan, you will receive a letter with further details on
the DEV project, including dependent eligibility criteria and an Amnesty
Disenrollment Document. During the amnesty period, we encourage you to
carefully review the definition on an eligible dependent and identify on
the Amnesty Disenrollment Document all ineligible dependents who should
be removed from your health plan.

Comment: There are many circumstances in which a de facto dependent is
not technically a dependent when it comes to enrollment in a health
plan. Enrolling such individuals is considered a criminal offense. Many
employers have instituted dependent verification programs in order to
ferret out this fraud. Is this really what we want to be doing?

It seems ironic that at a time in our history when theoretically we are
attempting to enroll as many individuals as possible in health insurance
programs, we are pushing a program designed to disenroll individuals
currently covered as dependents when they are not technically entitled
to such coverage.

We are expanding yet more administrative excesses which are resulting in
the opposite of our policy goals. That is, we are increasing the numbers
of uninsured through application of these dependent verification programs.

Wouldn't it be far simpler to have a system that automatically covers
everyone, regardless of dependency status or any other criteria? Instead
of advancing policies that make health care coverage a crime, shouldn't
we make health care a right for all?

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