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AG Gansler Joins With State, Federal Partners to Warn Consumers About Potential Health Insurance Fraud

Scammers often follow launch of government benefit programs; New tools streamline complaint process, share information across agencies, swiftly address privacy threats

Baltimore, MD (Sept. 19, 2013) – Attorney General Douglas F. Gansler today touted the launch of a coordinated effort among state and federal government agencies to protect against consumer fraud and privacy breaches in the health insurance marketplace. Attorney General Gansler met with U.S. Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius, Federal Trade Commission Chairwoman Edith Ramirez and Kansas Insurance Commissioner Sandy Praeger at the White House on Wednesday to discuss and formally kick off the intergovernmental initiative.

“State Attorneys General are on the front lines every day working to prevent scams and keeping consumers’ personal information secure,” said Attorney General Gansler. “We expect the implementation of the Affordable Care Act will likely give rise to attempts to exploit the public and we will work vigorously with federal stakeholders to educate consumers, investigate complaints and, where necessary, prosecute those who violate the law.”

At the White House meeting, attendees outlined and agreed on the following key initiatives:

  • Creating the Marketplace Call Center as a resource and referral to FTC for consumer fraud concerns, with trained Call Center staff to effectively refer consumer threats and complaints;
  • Connecting consumers to FTC’s Complaint Assistant through HealthCare.gov
  • Developing a system of routing complaints through the FTC’s Consumer Sentinel Network for analysis and referral as appropriate;
  • Establishing a rapid response mechanism for addressing privacy or cybersecurity threats, and;
  • Ramping up public education to empower consumers and assisters to know the facts and avoid scams.

The intergovernmental effort is intended to ensure consumers can confidently and securely shop for affordable health coverage that best suits them, beginning on October 1.

Consumers who report that their personal information may have been compromised will be given information about steps to take to prevent or respond to identity theft. If a consumer reports suspected fraud, his or her complaint will be entered into the FTC’s Consumer Sentinel Network database, which is used by federal and state law enforcement agencies to track potential fraud activity. Federal law enforcement officials will be able to monitor complaint activity for trends within and across all 50 states.

“At the FTC, we know all too well how scammers invariably try to take advantage of developments in the marketplace and new government programs,” said Chairwoman Ramirez. “We will be vigilant as always in cracking down on this type of opportunistic fraud.”

Scammers develop multiple ploys to deceive consumers into giving up their personal or financial information or to sell “discount medical plans” that may be neither discounted nor legitimate. A consumer should only give or verify their personal identifying information if they initiated the contact seeking enrollment with someone authorized to do so under the Affordable Care Act. The government will not call or email you to solicit enrollment in plans; consumers should be wary of calls from entities that are close in name to official government agencies or reputable health insurance companies.

Consumer fraud experts from both state and federal agencies will continue to meet regularly to monitor potential fraud associated with the health insurance marketplace and to evaluate and strengthen preventive measures where needed.

Steps have already been put in place to prevent and respond to individuals attempting to take advantage of the public during health care implementation. These measures include:

  • Reporting fraud mechanism: A new feature of the Marketplace Call Center (1-800-318-2596, TTY 1-855-889-4325) will now enable individuals to report fraud simply by calling the toll-free number. Call Center operators have been trained to take a fraud complaint, and refer them to FTC’s Consumer Sentinel Network.
  • Creating new pathways: HealthCare.gov makes it easy to connect consumers to FTC’s Complaint Assistant.
  • Establishing a routing system for complaints through a centralized database: Routing complaints through the Sentinel Network will ensure federal, state and local law enforcement have access to consumer complaints and can analyze and refer those complaints as appropriate.
  • Protecting personal data: Building on the certification of the Health Insurance Marketplace’s data hub as “in compliance” with the stringent security, privacy and data flow standards developed by the National Institute of Standards and Technology, the interagency officials have also established a rapid response mechanism that will be employed in the unlikely event of a data security breach.
  • Empowering consumers with information: Building on a proactive effort to inform consumers about potential fraud and privacy threats, the federal government is releasing new educational materials to empower consumers and assisters who are helping consumers navigate the marketplace. They include online tip sheets like Protect Yourself from Fraud in the Health Insurance Marketplace and Tips for Assisters to Help Consumers Navigate the Marketplace. The materials remind consumers that there is free assistance available to navigate the marketplace and that they should be suspicious of anyone who asks for payment before providing assistance.

Representatives from Attorney General Gansler’s Health Education and Advocacy Unit are attending an FTC forum today in Washington discussing how to empower and protect consumers from scammers with the implementation of the health insurance marketplace. That unit, in cooperation with the Maryland Health Benefit Exchange and the Maryland Insurance Administration, will be spearheading public outreach efforts to educate and warn consumers about potential scams and identity theft schemes.

For more information about the Maryland Attorney General’s Health Education and Advocacy Unit and their role in the marketplace, go to http://www.marylandcares.org.

For more information about a potential privacy breach in Maryland, go to http://www.oag.state.md.us/idtheft/index.htm. If you believe your privacy has been compromised, contact the Maryland Attorney General’s Identity Theft Unit at 410-576-6491.

For more information on the health insurance marketplace in Maryland, go to http://www.marylandhealthconnection.gov/.


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