Did you know Medicare loses an estimated $60 billion each year due to fraud, errors, and abuse? June 5th marks the beginning of Medicare Fraud Week. Listed below are some guidelines, current scams we’ve been notified about, as well as a link to the Senior Medicare Patrol website for more information on how to protect yourself.
Nebraska is currently in the top 10 of U.S. states reporting compromised Medicare numbers. How did the state get here? Most of this has happened due to cold calls to beneficiaries from various sources. The callers might say they want to send you a new Medicare card, but they need you to verify your information as to where to send the card. Some callers ask about your health such as “do you have any aches or pains in your back, knees, or shoulders?” What follows is a pitch to send you some braces to assist with helping relieve these issues and a request for the beneficiary’s personal information including Medicare number, address, and date of birth.
Be suspicious of doctors, health care providers, or suppliers that tell you:
- The equipment or service is free, and they only need your Medicare Number for their records
- Medicare wants you to have the item or service
- They know how to get Medicare to pay for the item or service
- The more tests they provide, the cheaper the tests become
Be suspicious of doctors, suppliers, or facilities that:
- Don’t charge copayments without checking on your ability topay
- Advertise “free” consultations to people with Medicare
- Bill Medicare for services, supplies, or equipment you didn’t get
- Put the wrong diagnosis on the claim so Medicare will pay
- Bill Medicare for tests you got as a hospital inpatient or within 72 hours of your admission or discharge
- Claim they represent Medicare or a branch of the federal government
- Use pressure or scare tactics to sell you high-priced medical services or diagnostic tests or threaten to withhold services
- Offer you money or kickbacks to use their services, join their plan, or let them use your Medicare Number
- Use phone calls and door-to-door selling as marketing tools
- Offer non-medical transportation or housekeeping as Medicare approved services
- Bill home health services for patients who aren’t confined to their home, or for Medicare patients who still drive a car
- Ask you to contact your doctor and ask for a service, supply, or equipment that you don’t need
- Bill Medicare for a back-brace or other orthotics, power wheelchair or scooter, or genetic tests when you don’t need one or don’t meet Medicare coverage rules
Current fraud activity in Nebraska:
- Fraudulent calls and text messages from CVS Pharmacy – the caller/message asks for personal identifying information to get prescriptions filled.
- New Medicare Card scam calls – phone calls asking for Medicare number, Social Security number, or a payment to get a new Medicare card.
- Plastic Medicare Cards scam calls – phone calls offering plastic Medicare cards in exchange for the Medicare number and/or payment.
- Genetic Testing scams – organizations approaching senior centers and retirement communities offering “free preventative cancer screenings” or “free testing to see your genetic makeup,” usually done via mouth swab. Medicare DOES NOT cover preventative genetic screenings.
- Back Braces and other durable medical equipment and supplies scam – phone calls asking for your Medicare number to send back braces, which are then shipped and charged for monthly.
How to protect yourself
- Do not give out your personal information. It’s okay to be rude and hang up on fraudulent calls.
- Safeguard all your information: Medicare number, Social Security number, banking and credit card information.
- Don’t carry your Medicare card unless needed.
- Only provide Medicare number to trusted providers.
- Know that Medicare does not call or visit you.
- Review your Medicare Summary Notices (MSN) and Explanation of Benefits (EOB), keep a record of your visits and match these up. Look at these items for potential fraud: charges for services not received, billing for the same thing twice, and services not ordered by the doctor.
- Reach out to a SHIP counselor and ask questions.
- Call your provider or Medicare.
- Refuse packages if you didn’t order them, call, and request a return label, and if it costs you to ship it back, don’t ship it.
For more information, visit the official website for Medicare Fraud Prevention Week.
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