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Illinois SMP Program Fraud Alerts
The Illinois SMP Program sends email Fraud Alerts every Friday. These alerts contain fraud-related news articles, information about current scams in Illinois or other parts of the United States, and useful healthcare or fraud-related resources. If you would like to be added to the Illinois SMP Fraud Alert email list, please contact:
Erin Weir, Healthcare Consumer Protection Coordinator
Phone: (800)699-9043, (708)383-0258
TTY: (708)524-1653
Fax: (708)524-0870
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Illinois SMP Fraud Alert - March 19, 2010
Dear SMP readers,
Today’s Fraud Alert is a little long, since we didn’t have one last week. If anyone has any questions about any of the information below, please feel free to contact me.
Sincerely,
Erin Weir, MSW, LSW, Healthcare Consumer Protection Coordinator
AgeOptions
1048 Lake Street, Suite 300
Oak Park, IL 60301
phone (708)383-0258 fax (708)524-0870
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Please share this Fraud Alert with colleagues, consumers, or other professionals in your area. If you have any questions about the Illinois SMP program, or to receive these Fraud Alerts directly, please contact Erin Weir, Healthcare Consumer Protection Coordinator at AgeOptions.
What you will find in this week’s Fraud Alert
- Illinois SMP Program Highlighted in the News
- Mail Scam Alert: “Stimulus & Citizens Relief Plan”
- IRS Warns of “Dirty Dozen” Tax Scams
- Wheeling Police Department Warns About “South African Switch”
- LifeLock Will Pay $12 Million Settlement
- CMS Terminates Fox Insurance Part D Plans
- Current Medicare Surveys
- Fraud in the News
Illinois SMP Program Highlighted in the News
AgeOptions recently issued a press release for National Consumer Protection Week about the SMP program and Medicare fraud prevention tips. That press release was picked up by a number of sources. Here are a few of the articles that resulted:
http://www.wjbdradio.com/?f=news_single&id=20722
http://www.fox2now.com/news/sns-ap-il--medicarescams,0,607135.story
Univision also ran a news story on Friday night on their 5 p.m. news about the Illinois SMP program. We don’t currently have a video of the report; if we are able to obtain one, we will send it in a future Fraud Alert.
Illinois SMP Partner, the Illinois Attorney General’s Office, was also featured in a Chicago Sun Times news story as a result of their own press release about the Silver Beat program:
http://www.suntimes.com/business/currency/2094705,CST-NWS-MSenior10.article
Mail Scam Alert: “Stimulus & Citizens Relief Plan”
A consumer in Metropolis, Illinois recently received a letter claiming to be from a “Stimulus & Citizens Relief Plan.” This letter uses very formal language, seals, etc. to appear like a government mailing. The letter states “Among various economic accelerant programs including corporate bailout efforts, relief giveaways, public grant and aid, stimulus packages – your identification herein subject to Award Opportunity Series AAA-4415 has been confirmed by File No. for the documentation presented to you as a resident of the State named above…” The letter goes on to state that the recipient is a “winner” of $2 million and eligible to receive a “silver-tone floating heart necklace with 4 sparkling crystals.”
This letter uses the current economic situation and related words like “stimulus” and “financial freedom” to try to scam the recipient into filing an application with the senders of the letter. This letter is very much a scam – anyone who receives it or anything like it should rip such letters up and throw them in the trash. Most importantly, consumers should not respond to any letter that offers money or other ‘winnings’ in exchange for an application, personal information, or payment.
IRS Warns of “Dirty Dozen” Tax Scams
In time for tax season, the IRS has issued a press release warning consumers about 12 prevalent tax-related scams. The release also explains how to report tax fraud: http://www.irs.gov/newsroom/article/0,,id=220238,00.html
Wheeling Police Department Warns About “South African Switch”
A Wheeling Police Officer recently issued the following warning about a scam occurring in Illinois:
“On 02-12-10 an elderly victim was approached by the male subject. The offender stated he was in possession of $100,000 and needed to donate the money before returning to Sudan. The victim drove the offender along with another male black subject to his bank and withdrew $6000. When the victim returned to his vehicle the offender snatched the money out of the victim’s hand. Both offenders fled on foot.
On 12-09-09 another elderly victim reported circumstances of a similar nature. In that case, the elderly victim was approached by a female subject who stated she was in possession of $100,000. In that case, the female offender said to the victim that she would give him $50,000 if the victim could produce $10,000. Both subjects went to the victim’s bank where the victim withdrew $10,000. The victim handed over $10,000 and received what he thought was $50,000 from the female offender. Both offenders fled the scene and the victim later realized what he thought was $50,000 was actually rolled up newspaper.
This type of con is called the “South African Switch”. In this type of scam, the suspect plays the part of a visitor from a foreign country. The suspect targets the victim for help in finding a non-existent location such as a church or hotel. The suspect then tells the victim that he/she has been awarded a large sum of money or a large settlement. The suspect will tell the victim that he/she cannot take the money back to their homeland. The objective of this scheme is to convince the victim (usually an elderly victim) that they are going to give him/her the money to distribute to charity and will also allow the victim to keep a portion for their troubles. Before doing so, the victim must withdraw some of his/her own money from the bank to show that he/she is trustworthy (act of good faith). Once the victim makes the withdrawal from his/her bank, the suspect(s) will use some type of distraction and disappear with the victim’s money.”
LifeLock Will Pay $12 Million Settlement
LifeLock, a company that offers identity theft protection and data security, is going to pay $12 million to settle charges by the Federal Trade Commission and the Attorney Generals of 35 states (including Illinois). The charges assert that LifeLock made false claims about its identity theft protection services, and therefore used deceptive marketing. For full information on the charges and the settlement, see the FTC press release here:
http://www.ftc.gov/opa/2010/03/lifelock.shtm
CMS Terminates Fox Insurance Part D Plans
Many of you may be aware that for the first time, the Centers for Medicare and Medicaid Services (CMS) terminated their contract with a particular company offering Part D prescription drug plans in recent weeks. Illinois has been included on a number of press releases regarding this termination of contract and its affect on current beneficiaries in the Fox Insurance Company’s plans. There are only 30 Fox beneficiaries in Illinois, and they are all located in Cook County. These beneficiaries will be placed into the LI NET program through Humana temporarily, so that they can choose a new plan. If they do not choose a new plan before April 30, 2010, CMS will assign them to a new plan. For more information, see this My Medicare Community thread: http://www.mymedicarecommunity.org/showthread.php?p=4954#post4954
Current Medicare Surveys
Medicare is currently conducting a survey called the Medicare Satisfaction Survey. Some Illinois beneficiaries may have received these surveys, along with a letter on CMS letterhead, signed by Walter Stone, CMS Privacy Officer. The survey is 15 pages long.
In addition, CMS has issued a notice of a second survey, the Medicare Health Outcomes Survey, which will begin in April. Here is the text of that announcement:
NOTE TO SHIP PROGRAMS AND THE AGING NETWORK:
The purpose of this notice is to communicate important information about the 2010 implementation of the Medicare Health Outcomes Survey (HOS). Please forward this information to colleagues, partners, contractors, stakeholders, customer service representatives and anyone else who might be asked questions about the survey, particularly by beneficiaries and family members.
The Medicare HOS is fielded annually across the country by CMS and used to improve the quality of care provided to people with Medicare enrolled in a managed care plan. Every year, Medicare beneficiaries are randomly selected from each Medicare Advantage plan to participate in the Medicare HOS. Selected individuals are surveyed twice, once at the beginning and once at the end of a two-year period. More information on the survey is available at www.cms.hhs.gov/hos.
On Monday, April 5, 2010, the Medicare Health Outcomes Survey (HOS) will begin data collection from beneficiaries who have been selected to participate in the thirteenth HOS baseline cohort.
On Monday, May 3, 2010, two-year follow-up data collection will begin for beneficiaries who initially responded to the eleventh HOS baseline cohort in 2008.
While staggered in implementation for ease of administration, the protocol will be identical for baseline and follow-up data collection. There will be a mailed pre-notification postcard, a first mailing of the survey, a reminder/thank you post card, a second mailing of surveys to people who did not return the first one, then a telephone interviewing component to those who did not respond to the second mailing (about one month after second mailing).
On April 5, 2010, a modified version of the Medicare HOS (HOS-Modified or HOS-M) will also begin data collection from beneficiaries enrolled in Program of All Inclusive Care for the Elderly (PACE) organizations. The HOS-Modified follows a similar protocol to HOS baseline and follow-up data collection but uses a shorter, modified version of the HOS instrument.
All data gathering activity will be complete on August 2, 2010. Attached is the complete 2010 timeline for baseline and follow-up HOS and HOS-Modified data collection activities.
As in previous years, the National Committee for Quality Assurance (NCQA) is CMS’ implementation contractor and will be using the services of six survey vendors:
DSS Research Fort Worth, Texas
DataStat Ann Arbor, Michigan
MORPACE International Farmington Hills, Michigan
Synovate McLean, Virginia
The Myers Group Snellville, Georgia
WB&A Marking Research Crofton, Maryland
Medicare Advantage organizations are free to contract with whichever vendor they choose; so, be aware that all vendors have business throughout the country and are not limited to specific geographic areas.
Thank you for your time and attention. I appreciate your assistance in helping to ensure that HOS and HOS-M 2010 are a success. If there are any questions, please feel free to contact me at 410-786-5609 or sonya.bowen@cms.hhs.gov.
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Fraud In The News
The following are current news articles about health care and fraud issues.
- 1. “Senior Medicare Patrol Fights Medicare Fraud”: http://www.seniorsforliving.com/blog/2010/03/08/senior-medicare-patrol-fights-medicare-fraud/
- 2. “Where Police Blotters Reigned, Texts Will Gain Fame” (Chicago residents can receive text or email message alerts regarding crime in their communities!): http://www.nbcchicago.com/news/local-beat/chicago-police-department-technology-E-87716867.html
- 3. Transcript of Obama’s Speech on Health Care and Fraud (transcript from Obama’s recent speech in St. Louis on health care fraud and health care reform): http://www.mainjustice.com/2010/03/10/obama-speech-on-health-care-waste-and-fraud/
- “Obama Using ‘Bounty Hunters’ For Health Care Fraud”: http://www.ksro.com/news/article.aspx?id=2043219
- “AARP Scam Alert: Cost of Internet Scams More than Doubled in ‘09”:
http://bulletin.aarp.org/yourmoney/scamalert/articles/
cost_of_internet_scams_more_than_doubled_in__report_
says.html?cmp=NLC-RSS-DAILY-BULLETIN
- “Health Care Fraudsters Adapt to Crackdown” (article about how Medicare fraud has changed in Miami in response to investigative efforts there): "Health Care Fraudsters Adapt to Crackdown"
- “AARP Scam Alert: Spring Cleaning, Dirty Tactics”:
http://bulletin.aarp.org/yourmoney/scamalert/articles/scam_alert_
spring_cleaning_dirty_tactics.html?cmp=NLC-RSS-DAILY-BULLETIN
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Fraud Alerts contain information about current scams taking place in Illinois, announcements and updates about programs or services related to health care and/or fraud protection, and links to news articles about health care and fraud topics. Please forward any recommendations or announcements that you would like to be included in a future Fraud Alert to erin.weir@ageoptions.org.
AgeOptions, the Area Agency on Aging of Suburban Cook County, is committed to improving the quality of life and maintaining the dignity of older adults and those who care about them – through leadership and support, community partnerships, comprehensive services, accurate information and powerful advocacy.
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