All,

FYI - See announcement on erroneous refund checks sent by Humana.

 

Ann

 

 

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Hello Everyone – CMS just shared that Humana erroneously processed some refund checks which impacted just under 10,000 beneficiaries.  Those impacted are all over the place geographically so please take a look at the attached to find the impact in your state.  Below you will find more details from CMS.

 

Best,

Rebecca

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Issue:

Humana erroneously processed a file used to generate member refund checks, which resulted in duplicate checks being sent to 9,699 Medicare members in error.

 

Root cause:

The original file processed on 5/5/2021 and generated the member communications as needed, but did not appear to finalize properly.  A Humana associate reprocessed the file on 5/10/2021 and confirmed that it finalized.  On 5/18/2021, Humana became aware of refund checks being declined for payment.  Research determined these to be duplicates of checks that had been issued from the original 5/5 file.  Of the 9,699 members who were sent duplicate checks, approximately 600 members have attempted to cash both checks.  The bank declined to pay the duplicate checks.

 

Impact: 

Receiving and attempting to cash duplicate checks could cause member confusion/dissatisfaction and could potentially result in bank fees assessed to members.  If that were to occur, Humana will honor requests for reimbursement of bank fees due to this issue.  The majority of the checks (83%) were for amounts under $50, with half the checks below $10.  Please see below for a breakdown of the check amounts.

 

Dollar Amount	Count	%
Under $10	5087	52.45%
$11-$50	2925	30.17%
$51-$100	714	7.37%
$101-$500	815	8.40%
$501-$1,000	93	0.96%
$1,001 - $5,000	63	0.65%
Over $5,000	2	0.0002%
Total	9,699	100%

 

 

Remediation:

We have provided our call center with talking points about the issue and how to request member reimbursement of any bank fees. We are in the process of making outbound member calls to alert members to the duplicate checks, and to offer to reimburse them for any bank fees due to the error.  We also plan to send a letter this week to all impacted members about the issue, which will include instructions for requesting reimbursement of fees.   We are researching why the original file appeared incomplete and will implement additional quality verification steps to prevent this from reoccurring. 

 

 

 

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