CHA Blog

• 14May

  FTC Turns to Public for Understanding & Preventing Senior Identity Theft ~ Comments Due 7/15/12

  Medicare fraud No Comments

  This year the Federal Trade Commission (FTC) is focused on how identity theft impacts elders and is soliciting information on this topic from the public. The FTC will use this information to inform its law enforcement agenda, policy initiatives and consumer education efforts.

  Elders are particularly susceptible to identity theft, as they are often the target of phone and phishing scams. Some elders have granted powers of attorney giving wide access to their personal information; and most elders’ Medicare cards list their Social Security numbers. In addition, their personal information can be vulnerable in hospitals, nursing homes, and other care facilities.

  During the current public comment period, the FTC is particularly looking for information on:

  1. The prevalence of identity theft targeting elders;
  2. The extent to which elders are vulnerable to identity theft;
  3. Types of identity theft schemes and the extent to which thieves use them to target elders, such as phishing schemes, power of attorney abuse, and tax, medicare, and nursing-home related identity theft;
  4. The extent to which elders are victims of familial identity theft;
  5. Precautions seniors can take to protect their identity when seeking accountants, financial advisors, nursing care, home care, and other medical services; and
  6. Public and private sector solutions to senior identity theft.

  Comments can be submitted to the FTC through July 15, 2012. While people can submit information electronically or in paper form, the FTC recommends you send them electronically for ease of retreival. Here’s the link: https://ftcpublic.commentworks.com/ftc/senioridtheft. If you do send in paper comments by mail,  send or deliver them to: Federal Trade Commission, Office of the Secretary, Room H-112 (Annex L), 600 Pennsylvania Avenue, N.W., Washington, DC 20580. Make sure you allow enough time for the FTC to receive them by July 15th as U.S. postal mail in the Washington area is subject to delay due to heightened security measures. Also make sure not to include any personal information in your comments as these will be open for public viewing.

  See this FTC announcement (PDF) with more information on this call for comments.

  Tags: elders, federal trade commission, identity theft, scams, seniors

• 11May

  Join Our SMP Director at National Summit on Elder Financial Abuse

  Medicare fraud No Comments

  Julie Schoen, our California Senior Medicare Patrol (SMP) Director will be speaking on “Advances in Stopping Fraud and Scams” at the 9th Annual National Summit on the Financial Exploitation of the Elderly on May 24th. If you are in the San Francisco area, come join in on this educational event organized by the Elder Financial Protection Network (EFPN).

  See information on speakers and the conference agenda.

  See information on the problem of elder financial abuse, identity theft, warning signs and how to report it.

• 09Apr

  CNBC Presents “Health Care Hustle” Tonight 4/9 at 9p.m.

  Medicare fraud No Comments

  If you’re available at 9p.m. tonight, CNBC is airing their 1-hour documentary on health care fraud.  Senior correspondent Scott Cohn and others on CNBC’s investigation crew joined a fraud strike team over a period of 6 months to get a firsthand experience of the fraud problem, and the new multi-agency, collaborative efforts and tactics being used the past 2 years since health care reform to find, prosecute and prevent criminals from milking the Medicare and Medicaid system.

  Fraud is one of the most expensive aspects of our health care system, costing American taxpayers and the Medicare system an estimated $80 billion per year — yet many say the real number could be as much as $160 billion. This is money going into the hands of fraudsters instead of into people’s care.

  View a press release on tonight’s documentary.

  See our Medicare fraud section for more information and resources on health care fraud, and for information on how to become a volunteer with our Senior Medicare Patrol project.

  Tags: documentary, health care reform, Medicare, medicare fraud, taxpayer dollars

• 02Apr

  OIG Features Fraud Alerts via Podcasts ~ Learn About Diabetes Phone Scams

  Medicare fraud 3 Comments

  The Office of Inspector General (OIG) has featured podcasts on its website covering a variety of current fraud alerts and topics. This is an easy way to listen and learn.

  Below is an excerpt of some helpful Q&As from their latest podcast on diabetes supplies phone scams. Note that while they direct people to report suspected fraud to their OIG hotline, we also request that you first contact your local California Senior Medicare Patrol (SMP) project. We will forward such reportings to the OIG and/or other government agencies as appropriate. Our California SMP helpline is 1-855-613-7080.

  Excerpt from the Podcast: Fraud Alert for People with Diabetes

  How do you know if a call is a scam?

  You should be suspicious of anyone who offers free Medicare items or services. Medicare does not make calls offering supplies or services to patients. So if someone calls you claiming to be from Medicare, it’s a red flag.

  Be wary of unsolicited calls because medical suppliers are not supposed to call you without prior permission. So if you receive an unsolicited call offering free supplies or other medical goods, you should be on alert.

  What if they ask you for financial information?

  You should be particularly suspicious of any callers who ask for your Medicare or any other financial information. These scammers may want to trick you into revealing your personal information by asking you to verify your Medicare number. Don’t give your Medicare number or other personal information to the caller. Once your Medicare information is in the hands of a criminal, not only can they charge items and services to Medicare in your name, but you are prone to further scams, such as identity theft.

  Can you give an example of diabetes supplies and some of the items that they’re offering?

  Typically, free diabetic supplies, such as glucose meters, diabetic test strips, or lancets. And the caller may also offer other medical supplies such as heating pads, foot orthotics, or joint braces, all in exchange for your Medicare number or banking information. Although the caller may claim these items are “free,” these are not free. They’re still billed to the Medicare program and still cost taxpayers money. We also have reports of people receiving excessive diabetic supplies and other medical supplies that they don’t want or need. Just know you are under no obligation to accept these items that you didn’t order. So instead, you should refuse the delivery and return it to sender.

  What should people do if they think they’ve been scammed and have received a suspicious call?

  You should report it to the OIG Hotline. That number is 1-800-HHS-TIPS. You can also report it online at our website OIG.HHS.gov. And, click on the big red button that says “Report Fraud.” As part of the report, it’s important to provide as much detail as you can about the call, such as the company’s telephone number and address, the company name, and a summary of the conversation you had. The more information you provide to us, the greater chance we can identify who the scammers are.

  What if you get medical equipment that you haven’t ordered?

  As I said, you should not accept items that you did not order. Instead, refuse the delivery and return to sender. And report this to the OIG Hotline, including the items that you received and the sender’s name.

  Are you concerned about medical identity theft as a result of these unsolicited calls?

  Absolutely. I want to emphasize how important it is to protect your personal information. You should not provide callers with your Medicare number, bank account information, or credit card numbers. I’d also like you to alert your friends and family about this scheme as well. Remind them not to provide strangers with their Medicare numbers or personal information. This Medicare number is basically the keys to the Medicare program, and they cannot commit fraud without it.

  Is there anything you want to add that you think is important?

  It is very important that you check your Medicare Summary Notices for items you didn’t order and didn’t receive. So be on the lookout for diabetic supplies that were billed multiple times. And report any irregular activity to your health care provider or call us at 1-800-HHS-TIPS.

   

  Tags: diabetes, diabetes supplies, fraud, Medicare, phone scams, podcast

• 28Mar

  Advocates Applaud New Federal Campaign to End Use of Antipyschotic Drugs as Chemical Restraints in Nursing Homes

  Long-term care insurance, Medicare fraud No Comments

  Advocates for nursing home residents who have been working for many years to eliminate all misuse of antipsychotic drugs for nursing home residents applaud the Centers for Medicare & Medicaid Services’s
  (CMS’s) new national initiative to address the drugging epidemic. CMS’s “National Initiative to Improve Behavioral Health & Reduce the Use of Antipsychotic Medications in Nursing Home Residents” will be announced via webcast on March 29, 2012 at 10:00 a.m. PST. “We thank former CMS Administrator Donald Berwick for his leadership in responding so forcefully to this national disgrace and for setting the wheels in motion to implement this long-overdue initiative,” said Janet Wells, Director of Public Policy, The National Consumer Voice for Quality Long-Term Care.

  CMS is developing a national action plan that includes raising public awareness of misuse of antipsychotic drugs, regulatory oversight, technical assistance, and research. The Initiative will be launched with a video streaming event at 1 p.m. EDT, March 29.
  http://surveyortraining.cms.hhs.gov/pubs/VideoInformation.aspx?cid=1098 Several hundred thousand nursing home residents with Alzheimer’s Disease or other dementia are given one or more antipsychotic drugs. The HHS Office of Inspector General reported last year that the overwhelming majority of Medicare claims for antipsychotic drug were inappropriate.

  In addition, hundreds of thousands of nursing home residents are inappropriately given antipsychotic drugs each day, despite the Food and Drug Administration’s ‘Black Box’ warnings that these drugs can kill
  residents who have dementia. Too many nursing homes use antipsychotic drugs as a way to control residents when they don’t have enough well-trained staff who know their residents well and can give them the time and attention they need. The word needs to get out that chemical restraints are as dangerous for residents as physical restraints.

  “Nursing home staff who take the time to understand what residents are communicating with their behavior can provide care to their residents without using chemical restraints,” said Claire Curry, Legal Director, Civil Advocacy Program, Legal Aid Justice Center, Charlottesville, Virginia. “We have seen good care like this in some facilities and know that all facilities can do the same.”

  Federal law, to a large extent, already prohibits the drugging of residents,” said Toby S. Edelman, Senior Policy Attorney, Center for Medicare Advocacy, Washington, DC, ”but the law is often too timidly enforced. CMS needs to dramatically step up strong enforcement of the law to ensure that all residents get the care and services they need, accor. CMS needs to ensure that no resident receives antipsychotic drugs except in full compliance with the law.”

  In August 2010, the California Advocates for Nursing Home Reform (CANHR) launched a campaign to end nursing home misuse of psychoactive drugs in response to the longstanding, widespread misuse of these drugs to chemically restrain residents. The campaign features a special website, educational presentations, consumer advice, administrative and legislative advocacy, stop-drugging blog and much more.  For more information about CANHR’s Campaign or the CMS initiative, please contact Michael Connors or Tony Chicotel,(415) 974-5171, or visit CANHR’s website www.canhr.org/stop-drugging.

  This blog article is taken from CANHR’s 3.28.12 press release.

• 05Mar

  82 Year Old Beneficiary Catches Medicare Fraud on Video

  Medicare fraud No Comments

  Last week an 82 year old grandmother caught her doctor committing fraud. With a hidden camera, Doris Ace of Texas, filmed her doctor’s visit where she clearly articulates that she is healthy and active. Despite some hypertension and arthritis, she is in good health and feeling great.

  Yet, contrary to her relatively clean bill of health, she was diagnosed as homebound, having a whole host of ailments that she does not have, including Type 2 diabetes. Such diagnosis opens the door for her providers to potentially bill Medicare for tens of thousands of dollars in home health care services, supplies and equipment she does not need.

  While federal authorities in Texas are currently investigating this case, Ms. Ace demonstrates the radical and important role each beneficiary can play in protecting their Medicare benefits and the integrity of the Medicare program.

  Read ABC’s news article for more info on this case. See our Medicare Fraud section for more information on how to prevent, detect and report fraud, and also how to become a volunteer with your local Senior Medicare Patrol (SMP) project. California’s SMP has over 450 volunteers statewide.

• 01Mar

  Help Stop Telemarketing Scams on Medical Alert Services

  Medicare fraud 1 Comment

  We recently received an alert from the Federal Trade Commission (FTC) regarding the  telemarketing of medical alert services. Marketers making unsolicited phone calls are attempting to pressure elderly consumers into buying medical alert services. The services supposedly allow consumers to receive help during emergencies by pushing a button on a pendant.

  Although many consumers reporting this scam have refused te buy the services, they continue to receive numerous letters in the mail demanding payment for the unwanted services. Typically, the letters contain phony invoices and threaten consumers with legal action if they do not immediately pay the false charges. Consumers have also received abusive follow-up phone calls from marketers and have even received packages in the mail containing unordered medical alert pendants.

  If you hear of or receive any such calls, please report them to our California Senior Medicare Patrol (SMP) project at 1-855-613-7080. We will forward on all reports to the Federal Trade Commission, which is the federal governmenfs consumer protection agency that brings federal court law enforcement actions to stop fraud and obtain refunds for consumers.

• 30Jan

  California’s Anti-Psychotic Drug Collaboration Uncovers Disturbing Truth of Illegal Drugging in Nursing Homes

  Medicare fraud No Comments

  The California Antipsychotic Drug Collaborative recently investigated 24 nursing homes and found 147 violations of state rules regarding the use of antipsychotics on residents. Their investigations confirm the disturbing and rampant misuse of antipsychotics in California nursing homes and call attention to a situation that deserves immediate remedial action.

  The Collaborative found that:
  • 63% of the surveyed nursing homes had violated state rules regarding informed consent;
  • 71% of the surveyed nursing homes were guilty of unnecessary and excessive drugging; and
  • 79% of the surveyed nursing homes had pharmaceutical services that were legally deficient.
  Some of the cases included fraudulent consents and consultant pharmacists who failed to identify dangerous contra-indicated drugs.  Every reviewed facility received at least one deficiency while several received more than a dozen.

  The California Advocates for Nursing Home Reform (CANHR) recently published a  report on the Collaborative’s findings, “In a Stupor: What the California’s Antipsychotic Drug Collaborative Reveals About Illegal Nursing Home Drugging” (PDF). CANHR also points out where the Collaborative falls short on corrective action and lists several items for advocacy in this area. The Collaborative results “cry for further state action to stem the crisis of chemical restraints.  The misuse of antipsychotic drugs is a leading form of elder abuse in nursing homes and it’s time that it stopped,” says Patricia McGinnis, Executive Director of CANHR.

  Read the report for more information.

  This article was edited from a CANHR press release.
• 21Dec

  Phone Scam Alert! Protect Your Identity

  Medicare fraud No Comments

  We’ve received another report of a Medicare telephone scam this morning. Please alert your clients to never give out personal information, including their Medicare and bank account numbers, over the phone to someone they don’t know.

  A woman in Chico called her local HICAP/Senior Medicare Patrol office to report a call from someone claiming to be “verifying Medicare information”. The caller said he was recording the conversation and asked to verify the client’s name, address, and bank account number, including her last check number. He then said she could ask questions at the end of the call.  Yet when she tried, he hung up.

  This woman then realized she made a terrible mistake by giving out her information, and immediately went to her bank to close/change accounts, and then called her local SMP office to report.

  We and other SMP offices around the country have received other similar reports. Please warn your clients and again remind them to protect their personal information.

  See Medicare Fraud for more info on common scams and how to detect and prevent them.

  Thank you, and Merry Solstice!!

  Tags: identity, medicare fraud, phone scam, protect identity, scam

• 12Dec

  Congressional Hearing on Medicaid Fraud Acknowledges SMP

  Medicare fraud No Comments

  In a U.S. House of Representatives Hearing on Medicaid Fraud last week, the sub-committee heard from a victim of fraud who spent 7 years in a lawsuit against Maxim Healthcare. This man specifically mentions calling the Senior Medicare Patrol (SMP) fraud hot line in New Jersey. Although he eventually hired a private attorney, he and the attorney both acknowledge the good work of SMPs.

  The hearing is worth watching and is a good reminder of why SMPs across the country, including our strong California team of staff and volunteers, do what we do!

  Here’s the Hearing: House Panel Hearing From Victim of Medicaid Fraud.

  See Medicare Fraud for more info on fraud and how to prevent, detect and report it. Also see our SMP Volunteer page if you’re interested in volunteering with our California SMP team.

  Tags: congress, hearing, medicaid fraud, medicare fraud, senior medicare patrol, SMP, testimony

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