Elliott Greenblott: FraudWatch: Medicare fraud steals from all of us

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50 billion to 90 billion dollars! That's how much money is lost to Medicare fraud ANNUALLY according to government and independent watchdogs. The actual number is lost somewhere between the two numbers due to the myriad of data collectors. Even at the low end of the range that number amounts to over $1,000 scammed for every Medicare recipient.

By now if you are a Millennial or GenX'er you are yawning and reaching for the sports page. Time to wake up and smell the liniment. This impacts on you! Medicare funding comes out of paychecks and provides medical service benefits to those over the age of 65 or disabled. If you currently work or have been in the workforce we are talking about YOUR money. Medicare fraud hurts everyone; young and old, current recipient and future recipient.

A primary motivation for this category of fraud can be summed up in one word - GREED. No surprise when considering the scammer, but my focus is on the target of the scam - Medicare recipients. They are drawn in by the word FREE. In these cases, people receive a phone call, an email, or even a postcard with the offer of free medical equipment such as back or knee braces, orthopedic devices, or even power wheelchairs. Quite often the criminal will make the offer and frame it as a matter of urgency indicating that there is a deadline for the response. As soon as the "victim" responds, he or she is asked to provide a Medicare account number and possibly some additional personal information. Assurances are made that this information will be kept in the strictest confidentiality and once again the word free is stressed. These offers are scams. There is no such thing as free. Medicare benefits are funded by money paid by beneficiaries, past and future. Even so, in most instances Medicare only covers 80 percent of the costs so items provided may still end up being billed to the recipient. In addition, the rules of the system require that the benefits obtained - braces, services, medical care - be prescribed by your attending physician. With many cases of Medicare fraud, unethical doctors are employed to certify patient needs in order to commit the fraud.

In a recent case, federal agents broke up a Medicare fraud ring arresting 24 individuals including doctors and 150 medical supply vendors operating in six states. They are accused of stealing $1.2 BILLION from Medicare and this is only the tip of the iceberg. There are clear steps you can take to fight these fraudsters as a Medicare recipient, family member, friend, or care giver. Notify Medicare by calling 800)-447-8477 or Vermont Senior Medicare Patrol 802)-229-4731 if there is receipt of a suspicious call or communications as described here or medical items that were not ordered. Medicare cards should be treated as important personal documents. Don't share the information on the card with anyone other than your care providers and don't carry the card in your purse or wallet unless it is needed.

Keep a personal log or record of medical appointments and purchases and use your records to check Medicare statements, insurance explanations of benefits, and medical bills to verify charges.

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If you get a call from "Medicare," hang up. Medicare will not call you and request your information.

Medicare benefits are based on eligibility established by need and prescribed by an attending physician. They are not provided with arbitrary time limitations or deadlines for obtaining benefits.

Ask questions! Contact the provider, Medicare, or Vermont SMP if you don't understand an entry on your Medicare Summary or don't recognize the item listed.

Scam alert: Scammers are hard at work in the wake of the catastrophic fire at Notre Dame Cathedral. Email pleas are targeting a variety of affinity groups including members of museums, art groups, and even the Catholic Church. Fraudulent campaigns are using web sites, emails, Facebook, and GoFundMe to scam individuals and one of these frauds raised over $400,000 from 14,000 people. Research before you donate by checking give.org, charitynavigator.org, or guidestar.org to search for red flags.

Elliott Greenblott is a retired educator and the Vermont coordinator of the AARP Fraud Watch Network and can be contacted at egreenblott@aarp.org


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