Medicare fraud

"If you receive a call pressuring you to buy medical equipment you don’t want or need, HANG UP!"

It’s estimated that Medicare fraud and abuse costs taxpayers more than $60 billion a year nationally. About 1.2 million Arizona seniors are eligible to receive Medicare benefits today.

A dense population of Medicare-eligible seniors creates a breeding ground for Medicare fraud, and a greater need for Senior Medicare Patrol (SMP) volunteers to protect this vulnerable population in our state.

Scammers typically gain their victim’s trust by claiming to be a credible professional such as a social worker or doctor, and prey on senior’s emotions by pretending to be their friend.

Furthermore, older adults who have experienced healthcare fraud may feel uncomfortable reporting the crime.

Arizona is ramping up its efforts to fight Medicare fraud with an awareness and volunteer recruitment campaign seeking retired and semi-retired professionals and others for its SMP project. SMP volunteers help preserve the Medicare benefit for their peers and generations to come.

They empower and assist Medicare beneficiaries, their families and caregivers to prevent, detect and report healthcare fraud, errors and abuse through community outreach, one-on-one peer counseling and education.

Volunteers receive a 30-hour training that covers the patrol’s mission, Medicare basics, how to recognize Medicare fraud and abuse and what to do about it.

For example, Medicare beneficiaries should be aware of durable medical equipment (DME) fraud schemes involving items like walkers; wheelchairs; and back, neck and knee braces. DME sent by a supplier must be prescribed by a doctor.

According to the Centers for Medicare and Medicaid Services (CMS), fraudulent telemarketing and DME supplies contribute to the estimated $60 billion in fraudulent Medicare payments each year.

Though it may end up being no cost to the person, it is costing Medicare, and until the abuse is reported, scammers will continue to get away with it.

 

To protect yourself:

If you receive a call pressuring you to buy medical equipment you don’t want or need, HANG UP!

If you received items in the mail you didn’t order, refuse the delivery or send the items back and report the incident to your local SMP office at 1-800-551-3191.

Medicare beneficiaries also should be cautious of getting billed for genetic testing or cancer screenings performed at community events and senior centers.

Representatives of genetic testing companies including insurance agents representing these companies, attend healthcare events at senior centers and housing complexes offering to perform screening and tests.

To protect yourself:

Do not give out your Medicare number or Social Security number and be cautious of unsolicited requests for this information. If your personal information is compromised, it may be used in other fraud schemes.

Do not consent to any lab tests at senior centers, health fairs or in your home. Be wary of claims that genetic tests and cancer screenings will be at no cost to you.

All x-rays, laboratory tests and other diagnostic tests must be ordered by the physician who is treating the beneficiary.

For more information on the SMP volunteer program, if you suspect Medicare fraud or would like more information on how to avoid a scam, call 1-800-432-4040 or visit smpresource.org

Christy Abrams coordinates the Senior Medicare Patrol as well as the State Health Insurance Assistance Program for the Arizona Department of Economic Security, Division of Aging and Adult Services.

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