I guess we kind of knew this would be coming.  imageThe social security death index is one item that can be used to see if you are dead or alive but there’s some errors in that data base too as some folks have had a hard time proving their alive.  One good thing is hopefully the pre-requisites needed here will leave out the “flawed data sellers” and hopefully not get a credit agencies in here either. 


Social Security Master Death Index Data Flawed–Over 31,000 Living Found in the Index

They want more recent information than your last income tax filing to verify all the information.  In addition the vendor will have to be able to reach across all 50 states to provide such verification…hmmm…interesting parameters here as there will be a number of sources to check and hopefully the information on hand will be correct.  Streamlined eligibility and enrollment sounds like an insurance company might be going after a contract like this or one of their subsidiaries as they will come in and state that they have the IT infrastructure to do the job, so we might see a few of those line up for the job and submit their proposals. 

I would to add one more item to this contract and that is to get a contractor that knows how to deal with “flawed data” and goes beyond just a basic algorithmic search when needed”.  We have seen such blunders at this one with the City of Buffalo paying premiums for dead employees in the past and hopefully not too many of them will be applying:) 

City of Buffalo Has Paid Over $2 Million to Provide Health Insurance for Hundreds of Dead People-Some as Many as 4 Years


Sure that was a little satire there but it makes a point of how this is such a big job and again such verifications will be subject to some kind of an audit in all of this.  As usual if you are not qualified as consumer I have no doubt that we will have to bear brunt and prove ourselves again as big business does that already with the information they mine and analyze and we all have to do it on our ticket.  Again hopefully there will be some credible sources used here and not some of the “junk” that is out there today, and that is why I wrote my series called The Attack of the Killer Algorithms” as most of those posts revolve around consumers being denied largely due to a lot of “flawed data” as they don’t get jobs, loans, etc.  Again I realize that some sort of qualification process has to take place and hope we are not so “junked” to the point of having credible data to do this efficiently and correctly.  As an example you would not want to see a company like this one, E-Scoring in there as you can’t see what information they have on you and they operate outside the arm of the law on a few technicalities.  I have actually wrote about them as Chapter 42 of the Attack of the Killer Algorithms series on how a company like the could get in here with insurance exchanges as the owner makes millions just mining and selling data.  Hopefully someone will be checking out thoroughly as to who gets this contract as we certainly wouldn’t want to stand further promoting such a business done that way when it comes to transparency with insurance exchanges. 

E-Scoring Credit Algorithms Invisible To Consumers Used to Market and Evaluate, Does Not Fall Under Federal Law And Such Are Used by Insurance Companies - How Will This Work With Exchanges –Attack of the Killer Algorithms Chapter 42

How many doctors are going to participate is yet on more question as here’s one example of the compensation being around 30% less, same issue basically that Medicaid has right now.   

Blue Cross in California Automatically Opts Doctors In for Insurance Exchange Participation And Reimbursement Looks To Be Around 30% Less Than They Receive Now For Individual Policies - Employer Provided Insurance Is Not Affected

 

Time to take a look at what we have built and see the reality of what’s out there and hopefully the credit and insurance folks might stay out of this to keep it fair.  We have enough issues with the multitude of errors already in their data bases.  All I can say is this is a big IT Infrastructure job set up and it needs to be done when?  October of 2013:)  What’s the old saying…”the short order code kitchen burned down years ago and we all missed the fire sale”…I should also add from the notes though that it appears that emailing and sending inquiries might suffice along with old SOAP protocols so maybe the level of sophistication and timing is somewhat being built in here.  BD 


Big Data, Flawed Data, Business Intelligence, Where’s The Future and What Has Been Our Past…A World With ”Algo Duping” of Society and Consumers


The Centers for Medicare and Medicaid Services wants industry help to provide current income and employment verification data services to support health insurance exchanges when they begin operations in January 2014

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CMS’ Center for Consumer Information and Insurance Oversight (CCIIO) needs a vendor to check wage and present employer information for accuracy when individuals apply for enrollment in qualified health plans on the exchanges under the Patient Protection and Affordable Care Act (ACA).

Interested vendors have until Jan. 7 to submit proposals for the one-year contract with four optional years.

Insurance exchanges must be able to perform a streamlined eligibility and enrollment process. Using a single, streamlined application, individuals can apply for enrollment in qualified health plans offered through the exchange and find out if they are eligible for insurance affordability support based on verification of their income.

A CMS federal data services hub will provide an applicant’s name, date of birth and Social Security number for the IDS provider to establish verification that is current within 45 days of the query for the employer and employment status and a 12-month historical pay summary. 

The IDS provider must develop technical integration requirements for the interface with the CMS data hub and deploy by Oct. 1, 2013. 

Information exchanges between the data service hub and the IDS will be transactional, real-time and synchronous, based on widely used standards, including:

  • Message exchanges between the hub and IDS will use Simple Object Access Protocol, or SOAP, message format
  • Hypertext Transfer Protocol, or HTTPS, will be the transport protocol
  • The message envelope will use Security Assertion Markup Language, or SAML 2.0, for security assertions, and Web Services Interoperability (WS-I) Security Profile, which establish underlying transport level security.

Beside income, health insurance exchanges will verify applicant information about citizenship/immigration status, residency, and access to minimum essential coverage through the federal data hub, state agencies and commercial sources.

http://www.govhealthit.com/news/cms-seeks-income-data-verifier-insurance-exchanges

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