AARP Fraud Watch Network: Medicare fraud

REGION – Several medical facilities, including the University of Vermont Health Network, recently experienced cyber attacks focusing on the patient portal containing personal information. Given the nature of these cyber attacks, it is reasonable to believe that the data in these computer systems also was compromised.

We are in the middle of the Medicare Open Enrollment period and the nonstop advertising on television proves the high-stakes nature of this. The Medicare open enrollment window is open until Dec. 15, 2020. This means you can enroll in an insurance plan or change your current plan to a supplemental or an advantage plan.

It is also a time for scammers! Before making any changes, conduct research into what plan is best for you and be sure that a plan offered to you is registered and promoted by a registered agent. There are numerous restrictions placed on providers that limit the kind of contact they can use. Contact from providers with which you do not have a relationship is prohibited.

In 2019, at least $60 billion was lost to Medicare fraud and additional unnecessary costs were the result of errors. Medicare fraud basically occurs across the system: medical care, telemedicine, home healthcare, hospice care, diagnostic testing, transportation, and prescription drugs.

Criminals see Medicare as an easy target given that there are nearly 50 million beneficiaries. Identifying the potential victim is easy since virtually all citizens over the age of 65 are in the pool. Scammers target seniors in numerous ways. Impersonators use phone calls and emails to extract personal information such as Medicare and Social Security account numbers, family information, and more. The information is then used to commit theft from the victim through phony credit cards, loans, and bank accounts. The data is also used to steal from the system by filing fraudulent benefit claims. While this crime does not take money directly out of the pockets of individuals, it indirectly steals from people of all ages and places stress on the entitlement system for seniors.

Social media is yet another platform for fraud. Messaging is used to promote false claims related to products or treatments, which sets the stage for identity theft and monetary losses.

Impersonators make threats stating that there were missed payments or fees which, if not paid, will result in termination of benefits. All the victim needs to do is purchase some gift cards and read the card number to someone on the phone in order to resolve the problem. A third scheme involves approaching beneficiaries with offers of “free” medical equipment or services such as motorized wheel chairs, braces, home health checks, or diabetic services.

Avoiding Medicare scams is not easy but it is possible through skepticism and vigilance, and here are some key red flags: Medicare – and Social Security – will not call or email you demanding information or money and clearly no state or federal agency would ask for payment with gift cards; legitimate medical providers will not contact you promoting “limited availability” offers; if you are offered a “just discovered” cure or vaccine know that such a discovery will be announced in public media, not via a personal phone call or email message.

If you find yourself, a family member, or a person you know is either a target or a victim of Medicare fraud, report it to your state Senior Medicare Patrol: New Hampshire 866-634-9412 or Vermont 888-865-2683. You can also report the scam to the Federal Trade Commission at www.reportfraud.ftc.gov.

Questions, concerns, comments?  Contact me at egreenblott@aarp.org.

Elliott Greenblott is a retired educator and coordinator of the AARP Vermont Fraud Watch Network. He hosts a CATV program, Mr. Scammer, distributed by GNAT-TV in Sunderland, Vt.

Back To Top