Acting Medicaid Director Sandy Terrell Releases Information on Medicaid Card Incident

Raleigh, N.C.

Today, Department of Health and Human Services Acting Medicaid Director Sandra Terrell released the following information regarding the incident which incorrectly mailed 48,752 Medicaid cards to wrong addresses:

  • Effective January 1, due to new eligibility rules and requirements under the Affordable Care Act (Obamacare), 70,253 children were switched from NC Health Choice to Medicaid. As a result, the N.C. Department of Health and Human Services had to issue new Medicaid cards to these children, and it has been determined that 48,752 of them were mailed to the incorrect recipients.
  • DHHS mailed the Medicaid cards to incorrect recipients on Monday, December 30, 2013. The incorrect card shows the child's name, Medicaid identification number, date of birth and primary care physician. On Tuesday, December 31 (New Year's Eve), staff within the Medicaid Division and NCFAST first received reports that some recipients received incorrect Medicaid cards. Staff from within the Medicaid Division sent an automated message to all county departments of social services informing them that some Medicaid cards had been issued with incorrect information. DHHS leadership was informed of the issue on Thursday, January 2, 2014 and requested an analysis to determine the extent of the problem and its cause. On Thursday, after an analysis of the issue, staff preliminarily determined that potentially 48,752 Medicaid cards were incorrect. This number was confirmed and validated on the morning of Friday, January 3, 2014. The Governor was first informed Thursday evening and received updates on Friday.
  • Staff at the Department of Health and Human Services is working through the weekend to continue conducting a full-scale review of this incident and to get people their correct Medicaid cards as soon as possible. Additionally, DHHS is meeting its legal obligations when a potential HIPAA breach is identified. Federal laws and rules require that DHHS go through an analysis to first determine this incident meets the legal requirements to be considered a breach of protected health information. If confirmed, HIPAA breaches must be reported within 60 days of the incident. DHHS privacy and security staff continue to work on that assessment through the weekend as a part of our comprehensive review.
  • In terms of next steps, Medicaid recipients will be issued new Medicaid cards with new Medicaid ID numbers as soon as possible. By issuing new Medicaid ID numbers, the mistakenly sent Medicaid cards will be invalid. Issuance of a new Medicaid number will mitigate potential misuse of the incorrectly issued cards. Additionally, the Medicaid Division will flag the affected Medicaid ID cards within DHHS' computer systems to treat them with extra scrutiny and caution. DHHS will be alerted if those compromised cards are used.

DHHS is working to notify the public, legislators, providers and affected recipients as soon as more information is available. Affected recipients can call our Customer Service Center at 1-800-662-7030 during normal business hours on Monday-Friday if they have any questions or concerns.