Fraud Prevention Highlighted During Medicare Fraud Prevention Week

CMS/Medicare

ALBANY, New York—Fraud costs Medicare an estimated $60 billion per year according to the New York StateWide Senior Action Council.

It costs Medicare beneficiaries time, stress, their medical identities and potentially their health. It costs families, friends and caregivers in worry and lost work when helping their loved ones recover from falling victim to Medicare fraud.

“Medicare fraud has a devastating impact on both beneficiaries and the Medicare program,” said Maria Alvarez, executive director, New York StateWide Senior Action Council (StateWide), the administrator of New York’s Senior Medicare Patrol (SMP) program. “We inform the public how to avoid experiencing Medicare fraud. By preventing fraud from happening, this program helps individuals and protects the Medicare program for generations to come.”

Learn how to protect yourself and your loved ones by joining the SMP and its partners for Medicare Fraud Prevention Week, June 3-9. This observance focuses on June 5, or “6-5,” because most people become eligible for Medicare when they turn 65 years old.

Examples of Medicare Fraud by health care providers include:

  • Charging for services or supplies that were not provided
    Misrepresenting a diagnosis, a person’s identity, the service provided, or other facts to justify payment
    Prescribing or providing excessive or unnecessary tests and services

Alvarez advises seniors and their caregivers to follow these three steps to prevent Medicare Fraud:

  • PREVENT: Open and read your Medicare statements.
    REPORT: Contact the NYS Senior Medicare Patrol if you suspect fraud, errors, or abuse.
    DETECT: Look for provider names or services you don’t recognize.

Everyone plays a part in the fight against fraud. During Medicare Fraud Prevention Week:

  • Medicare beneficiaries can monitor their insurance statements to make sure products and services received match what is on the statements. They can request free My Health Care Trackers (an online resource to track and document all health care-related products, services and treatments) from StateWide by calling its toll-free Helpline at (800) 333-4374 or visiting StateWide at www.nysenior.org.
  • Caregivers can help by being on the lookout for items such as durable medical equipment (like boxes of knee braces) lying around the house that may have been shipped to the beneficiary without their or their doctor’s approval. They can remind their client or loved one to never give out their Medicare number or other personal information over the phone.
    Families can help by talking to their loved ones about protecting their Medicare number just as they would a credit card number. They can help their loved ones create a Medicare.gov account to access their Medicare statements online or remind them to open and review them when they come in the mail. They can also register their phone number on “do not call” lists and go to optoutprescreen.com to opt out of mailings.
  • Partners and professionals can help by sharing SMP information on social media, referring clients and consumers to the SMP, and inviting the SMP to speak during a shared event.
  • Health care providers can help by talking to patients about health care-related scams such as those related to durable medical equipment and genetic testing schemes. They can remind them that products and services should only be ordered by physicians they regularly see. Needed medical items should never be ordered through TV ads or unsolicited calls.
  • Community members can help by looking out for older neighbors. When in public, they can be aware of older individuals purchasing gift cards in large amounts. They can encourage those they know to talk to a trusted source about their Medicare questions and tell neighbors about the most recent Medicare scams. They can even consider volunteering with StateWide’s SMP.

The NYS Senior Medicare Patrol (SMP) can provide the information needed to protect consumers from Medicare fraud, errors and abuse; detect potential fraud, errors and abuse; and report concerns. SMPs help educate and empower Medicare beneficiaries in the fight against health care fraud. The NY SMP also provides information and educational presentations.

Call the NY SMP toll-free number at (800) 333-4374 or visit nysenior.org for any questions regarding Medicare fraud. Certified counselors are ready to help regarding Medicare benefits, and issues as well as Medicare Fraud Prevention Week.

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