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 - March 5, 2010

Dear SMP readers,

Today’s Fraud Alert contains a long version of Fraud in the News – there has been a lot of news this week! Not many new scams to report this week, but I have still been receiving a large number of reports from residents in senior buildings who have been approached by home health and/or durable medical equipment companies in their buildings, offering them ‘free’ services. I have also received reports recently of similar issues with door-to-door sales from people living in single-family homes. What many of these people have found is that these companies have then billed Medicare and/or Medicaid for expensive health care services that they did not provide, or that were different than what was provided. It is very important that consumers are alerted about solicitations like this – in particular, please remind Medicare and Medicaid beneficiaries in your area to only provide Medicare or Medicaid information to their known, trusted health care providers – NOT to someone who calls on the phone or comes to the door, especially if they offer “free” services. (Note: This advice applies to private insurance information, as well!) To view a PowerPoint presentation and tip sheet about Medicare’s home health coverage and tips about avoiding home health fraud, please visit our website at www.illinoissmp.org. Click on “Illinois SMP Materials” on the left side of the screen. The home health tip sheet and PowerPoint are included on this “Materials” page.

Have a wonderful weekend!

Sincerely,

Erin

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

• Fraud in the News

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Fraud In The News

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

1. AARP Scam Alert: My Grandson, the Crook (this week’s AARP Scam Alert is about the Grandparents Scam): AARP Scam Alert
   
   
2. “Medical Identity Theft is Costly For Victims” (article about the dangers of medical identity theft):
   "Medical Identity Theft is Costly For Victims"
   
   
3. “Phony Health Insurance Plans on the Rise, Impacting Collections” (this article discusses the increase in fake insurance plans that is causing consumers to go into extreme medical debt): "Phony Health Insurance Plans on the Rise"
   
   
4. “CVS Caremark Subpoenaed Over Medicaid Claims” (the Office of the Inspector General is requesting records from CVS Caremark as part of an investigation into potential false or improper Medicaid claims): "CVS Caremark Subpoenaed Over Medicaid Claims"
   
   
5. “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"
   
   
6. “Miami Medicare Fraud Scheme and Threats Lead to Prison” (article about an equipment supplier who was recently sentenced to over 9 years in prison. The two Medicare contractors that received threats from this individual are two of the same contractors who investigate Medicare fraud and abuse in Illinois): "Miami Medicare Fraud Scheme & Threats Lead to Prison"
   
   
7. “Medicare Equipment Company that Charged Medicare Two Braces For a One-Legged Texas Man Pleads Guilty” (article about the recent conviction of a medical equipment supplier in Texas that was marketing “arthritis kits”): "Medicare Equipment Company..."
   
   
8. “Medicare Suspends Marketing and Enrollment For Fox Insurance Company Drug Plan” (Medicare press release about the suspension of Fox Insurance Company from marketing or enrolling people into their Medicare Part D plans. Note – this company does not appear to be operating in Illinois.): "Medicare Suspends Marketing & Enrollment..."
   
   
9. Centers for Medicare and Medicaid Services (CMS) Plan to Expand Oversight of Part D Plans’ Fraud and Abuse Programs (Government Accountability Office study that talks about the audits that have taken place in relation to Medicare Part D plans and CMS' plans to expand the oversight of the plans' fraud and abuse programs): http://www.gao.gov/new.items/d10481t.pdf
   
   
10. MEDICs Testify Before Senate Committee (MEDICs are the Medicare contractors who investigate fraud, waste, and abuse in the Medicare Prescription Drug Program. This gives testimony from both the Compliance and Enforcement MEDIC and the Benefit Integrity MEDIC to the Senate Committee on Homeland Security and Governmental Affairs.  The testimony gives a good summary of MEDIC activity since its inception.): MEDICs Testify Before Senate Committee
    
    
11. Marketing and Compensation Concerns With Medicare Advantage (This report from the OIG presents vulnerabilities that still exist in relation to Medicare Advantage marketing and agent activities and compensation.): http://www.oig.hhs.gov/oei/reports/oei-05-09-00070.pdf

 

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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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