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

erin.weir@ageoptions.org

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Illinois SMP Fraud Alert - February 12, 2010

Dear SMP readers,

Happy Valentine’s Day!  I hope that everyone has a wonderful Valentines and Presidents Day weekend. Below you will find updates on current scams, as well as a notification about a Health and Human Services survey that is NOT a scam. I’ve also included a clarification of a statement in last week’s Fraud Alert.

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

erin.weir@ageoptions.org

ageoptions.org

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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

• Clarification from Last Week’s Fraud Alert
• Research Triangle Institute Survey Not a Scam
• ComEd Issues Fraud Alert about Fake Utility Workers
• Scam Updates From Other States
• Fraud in the News

Clarification from Last Week’s Fraud Alert

Last week's Fraud Alert included a story called "Chicago Senior Receives Call 'from Medicare.'" I wanted to make a clarification of something that was stated in that story. I said "The only situations in which Medicare may contact someone via phone would be 1) to follow up on a contact that the person made initially, or 2) to conduct a survey." That statement leaves out an important 3rd possibility - a Medicare contractor following up with a beneficiary to ensure that the beneficiary received certain services. For example, such follow-up will generally always occur when someone submits a fraud complaint to Medicare or through the Illinois SMP program. When an individual submits a complaint about potential fraud, we refer that complaint to a Medicare contractor for investigation. Therefore, that contractor is going to follow up with the complainant via a phone call. The same thing would happen if the person files a complaint with 1-800-Medicare.

On some occasions, one of these Medicare contractors may contact a beneficiary about a potentially fraudulent claim even if the beneficiary did not submit a complaint. Medicare's Program Safeguard Contractors (fraud and abuse investigators) do a large amount of work to root out fraud and abuse through Medicare data, in addition to receiving beneficiary complaints. As a result, a contractor may come across a particular claim that they need to verify with a beneficiary, and to do so, will contact the beneficiary directly.

I apologize for leaving this important detail out of last week's story. This type of contact still 'fits' with the SMP message that consumers should NEVER give their Medicare number or other personal information out to someone who contacts them on the phone. If the call is truly from Medicare or a Medicare contractor, they will already have access to that information. Medicare does not call to sell anything, and Medicare does not endorse any particular company, so someone who calls and offers "free" services or supplies, as in the story from last week, is definitely not calling from Medicare.

Research Triangle Institute Survey Not a Scam

The Nebraska SMP alerted us this week to a survey that is taking place through the United States Public Health Services. Some Nebraska seniors have been receiving a letter from the Research Triangle Institute (RTI) regarding a study being conducted nationally on health-related issues. The letter is on HHS (Department of Health and Human Services) Stationery. It states that an RTI interviewer will be coming to the resident’s home to interview the person and have him/her complete a survey. Survey respondents will receive $30 cash for completing the interview. The letter also contains a sample ID card that will be carried by the interviewer. The Nebraska SMP researched the situation and found that this is a legitimate survey – not a scam.

ComEd Issues Fraud Alert about Fake Utility Workers

A coworker sent me the following alert, issued by ComEd this week and shared in the Riverside News:

“Because of a rash of incidents involving individuals posing as utility workers to gain access to senior citizens' homes, or to obtain personal information by phone, ComEd reminds its customers not to allow entry to persons claiming to represent the company without first asking for and viewing proper identification.

In recent incidents in Chicago, Rockford, Belvidere and DeKalb, customers have reported that individuals claiming to be ComEd representatives have requested personal banking or credit card information, or offered to collect cash for a payment from their homes. 

ComEd reminds its customers that ComEd representatives' all have identification badges which are clearly visible and carry both a name and photograph, and their clothing has the ComEd logo.  ComEd representatives do not:

* Request private information, like credit card numbers by phone, or
* Pick up payments of any kind at customers' homes

Should any customers suspect fraudulent activity of this kind, they are encouraged to call the police. 

Any customers seeking more information regarding how to be sure if a person is a legitimate representative of Com Ed, or the appropriate ways to make payments are encouraged to call 1-800-EDISON1.”

Scam Updates from Other States

On a recent SMP conference call, various states reported scams that they have been hearing about in their respective states. Here are a few examples:

• The Mississippi SMP had a consumer report a phone call where the caller stated that he was a government worker, calling to notify the consumer that he would be one of 1200 people receiving a $7500 Pell grant. However, the caller wanted personal information from the consumer – a key indicator of a potential scam. (Note: Pell grants are educational grants, and an individual must apply to receive one.)

• The California SMP has received reports of a Durable Medical Equipment (DME) supplier going into a nursing home and fitting every resident for diabetic shoes, regardless of whether the residents needed the shoes or not. They have also been told that the supplier has ‘moved on’ to another nursing home in the area. (If anyone notices practices like these in nursing homes or senior buildings in Illinois, be sure to report them to the Illinois SMP – (800)699-9043.)

• A Medicare beneficiary in Hawaii reported receiving a phone call from someone claiming to be from the FBI and investigating possible victims of fraud. The caller asked for personal information. (Again, the key here is that the caller asked for personal information – if the FBI or another agency is contacting you to investigate a fraud report, he/she will NOT ask for your Social Security number, Medicare number, etc. over the phone. They already have access to that information.)
  
  

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Fraud In The News

The following are current news articles about health care and fraud issues.

1. AARP Scam Alert: The Check May Look Real, But It’s Not (AARP Scam Alert article about new twists on fake check scams):
   AARP Scam Alert 1
   
   
2. AARP Scam Alert: Playing for Money (AARP Scam Alert article about the dangers of playing online games): AARP Scam Alert 2
   
   
3. “Fraud Patrol: For Senior Volunteers, SMP Program is a Worthy Retirement Plan” – advanceweb.com (article about SMP volunteers in Maine and Pennsylvania): "Fraud Patrol"
   
   
4. “FTC Probing CVS Caremark’s Prescription Drug Practices” – Washington Post (article about an FTC investigation of complaints regarding CVS Caremark; includes a quote from Illinois Representative Jan Schakowsky): "FTC Probing CVS Caremark's Prescription Drug Practices"
   
   
5. “Popular New Medicare Supplement Faces New Hurdles” (discusses fraud and abuse involving insurance agents in Minnesota):
   "Popular New Medicare..."

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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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