New York Fingerprint Identification at Point of Service Abstract

In 2007, 27 states received Medicaid Transformation Grants under Section 6081 of the Deficit Reduction Act of 2005. The grants were rewarded to states that proposed innovative methods which in the end of the two years are designed to produce better health outcomes at lower cost.

The Center for Health Transformation is highlighting states that have received these Medicaid Transformation Grants, and will be following their progress for the next two years. In order for key decisionmakers and industry leaders from around the country to learn from others’ successes, it is our intention to provide this resource in order to showcase innovative practices from across the nation. In the future, this site will be interactive, allowing program directors to submit updates and comments regarding their program.

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The Cardswipe/Post and Clear (P&C) Program was developed in 1990 to respond to the large number of services being billed and not provided and to the high incidence of services ordered and prescribed that were not legitimate. Many orders, prescriptions, and billed services are generated by recipients and physicians working in concert to defraud the Medicaid program. Requiring providers to swipe their services through Medicaid Eligibility Verification System (MEVS) terminals reduces illegitimate services, as well as the number of forged prescriptions.

A serious problem remains, however, regarding the incidence of Client Identification Number (CIN) card loaning/renting, whereby recipient cards are used to obtain services/medications by individuals other than the actual recipients and by unscrupulous providers who generate claims without providing actual services.

In this proposal, at the time of service, the provider would swipe the recipient’s PA/MA card, and the recipient would put a finger on a small scanning machine to authenticate that the card holder (established at enrollment) is the person getting the service. The authentication would be accomplished by sending the unique card ID and the fingerprint data obtained from scanning to a central site for comparison to the fingerprint data corresponding to the card number. Based on the comparison, a response would be returned indicating whether the individual present at the location was the same individual enrolled for that card number. Equipment necessary at the point of service includes the Verifone Omni 3750 cardswipe machine (which accepts Visa, Mastercard, Discover Card, and American Express) and a special-purpose unit which performs fingerprint reading and comparison algorithms. New York State Office of Medicaid Management (OMM) currently utilizes a Post &Clear/Card Swipe program employing the Verifone Omni 3750, thus enjoying a jumpstart on the equipment utilized, and, as a result of this project's rollout, we would expand the card-swipe project as well.

For this project, we propose using a vendor for detailed analysis and project coordination which would include working with the New York Office of Temporary and Disability Assistance (OTDA) and their Automated Fingerprint Identification System (AFIS) vendor, SAGEM Morpho. SAGEM Morpho is the world’s largest biometrics company, develops, manufactures, and integrates multiple biometric technologies including fingerprint, iris and facial recognition products and services.

In order to leverage existing equipment we would focus on the 11,000+ locations where Verifone Omni units are already deployed. These sites, which include 1,200 pharmacies and a a variety of hospitals and clinics, would only require the addition of the fingerprint scanning unit. We would then begin to add additional service providers and provider types which would receive both the Verifone device and the fingerprint scanning unit.

By more aggressively monitoring Medicaid prescription practices, the project will:

• reduce the number of fraud cases arising from identity fraud and abuse.
• facilitate the transition to new technology to prevent waste, fraud, and abuse without reducing the availability of services provided to Medicaid recipients.
• maximize efficiency and resource costs in the Medicaid program.