Avoid Becoming Victim of Medicare Frauds and Scams

3/17/2012

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By Randy Hutchinson

President of the BBB

Special to The Commercial Appeal

A consumer recently contacted us to help determine if a call she received was a scam. The caller offered to send her new Medicare cards, including one that offered extra benefits, then asked for the name of her bank. The consumer wisely hung up and contacted us.

It’s a scam that some seniors fall for. The crooks claim to represent Medicare or another government agency and ask consumers to update information in order to receive their Medicare cards or benefits. If the crooks can get banking information, they’ll use it to commit identity theft.

These crooks can be very aggressive, often calling many times and at all hours of the day to wear down their potential victims. They may even have limited information about the person that’s easily gleaned from public databases that they use to make the call seem legitimate.

Medicare, Medicaid and the Social Security Administration will not call you to update information or issue a new card. If you get one of these calls, hang up and report it to the Centers for Medicare and Medicaid Services. We want to keep the public informed of all the scams active in our area (a daunting task), so please let us know at the BBB also.

Most of the Medicare related scams the BBB hears about are some form of identity theft. Medicare, the FTC and other government agencies warn about other types of Medicare fraud that cost taxpayers billions of dollars a year. They include:

  • A health care provider or supplier bills Medicare for services or equipment you never received.
  • Someone uses another person’s Medicare card to get medical care, supplies or equipment.
  • Someone bills Medicare for home medical equipment after it’s been returned.
  • A company offers a Medicare drug plan that has not been approved by Medicare (calling seniors under the pretense of enrolling them in a drug plan is another common identity theft scam).
  • A company uses false information to mislead you into joining a Medicare plan.

The FBI says that seniors are frequent targets of medical equipment manufacturers who offer them free medical equipment in exchange for their Medicare numbers. Medicare won’t pay for equipment without a doctor’s signature certifying it’s necessary, so con artists fake signatures or bribe corrupt doctors to sign the forms. Then they bill Medicare for equipment that wasn’t needed or wasn’t ordered.

The FBI offers this advice to avoid becoming the victim of Medicare and other healthcare related frauds:

  • Never sign blank insurance claim forms.
  • Never give blanket authorization to a medical provider to bill for services rendered.
  • Ask your medical providers what they will charge and how much you’ll have to pay out-of-pocket.
  • Carefully review your insurer's explanation of benefits statement. Call your insurer and provider if you have questions.
  • Don’t do business with door-to-door or telephone salespeople who tell you that medical services or equipment are free.
  • Give your insurance/Medicare identification only to those who have provided you with medical services.
  • Keep accurate records of all health care appointments.
  • Know if your physician ordered equipment for you.

Most doctors, health care providers and suppliers who work with Medicare are honest. Don’t end up with one of the few who aren’t.

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