Friday, March 13, 2015
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In This Issue
Fraud in the News
New SMP Materials Show How Home Health Should Work & Why Fraud Is Bad
Illinois Nurse Charged with Health Care Fraud: Example of Home Health Fraud
Spreading the SMP Message in Your Community
 
Fraud in the News
The following are current news articles about health care and fraud issues.

 

Consumer Fraud: 

 

1. "You (Haven't Really) Won!" (FTC)

 

2. "In Payday Loan Debt? Don't Let False Promises Sink You in Deeper" (FTC)

 

3. "Cleaning Up without Getting Cleaned Out" (FTC)

 

4. "A Billion Illegal Robocalls" (FTC)

 

5. "Don't Get Scammed by Investment Fraud on the Internet" (NCPW)

 

6. "There Is No Bureau of Defaulters" (FTC)

 

7. "The Grate Pretenders" (FTC)

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 Jason Echols, Healthcare Consumer Protection Coordinator at AgeOptions.

 

This document was supported in part by a grant (No. 90MP0163 & 90SP0061) from the Administration on Aging (AoA), Administration for Community Living (ACL), U.S. Department of Health and Human Services (DHHS). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official AoA, ACL, or DHHS policy. 

  

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Dear SMP Readers, 

 

This week's Fraud Alert features two new SMP materials on home health fraud, a recent home health fraud indictment, and a community presentation from one of our partners.

 

Have a great weekend!

 
New SMP Materials Show How Home Health Should Work & Why Fraud Is Bad

Home health fraud is a huge problem in Illinois. It remains the number one type of Medicare fraud complaint that the Illinois SMP hotline receives, and our law enforcement partners continue to cite it as a major problem they are seeing as well.

There are legitimate times when beneficiaries need home health services, but how do you know if you qualify for home health? What are the signs of home health fraud? What can you do to prevent it?

The Illinois SMP at AgeOptions has just released two new materials to help beneficiaries understand Medicare's home health benefit and how to prevent home health fraud. The first is a one-page visual summary of home health fraud, and the second is an article that goes into further detail. Download these two materials at www.illinoissmp.org:
The main take away from these two materials is to always have and always work with your own doctor that you know and trust and who knows you. You and your doctor together should be the only people deciding what care you need.
 
Illinois Nurse Charged with Health Care Fraud: Example of Home Health Fraud

This week, a registered nurse in Illinois was charged with health care fraud for billing Medicare for approximately $5 million in unnecessary services over 3 years. Read more in this U.S. Department of Justice (DOJ) press release. (As this release reminds us, indictments are not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial.)

This case presents an example of home health fraud (see the first story in this week's Fraud Alert about new SMP materials on home health fraud). The charges state that this nurse and the two companies he worked for allegedly billed Medicare for skilled care provided to people who were not homebound but were made to appear homebound in supporting documents sent to Medicare. The press release also notes two Medicare beneficiaries who worked with law enforcement to report these fraudulent activities. Their willingness to come forward helped bring charges against these alleged fraudsters. If you have experienced health care fraud, call the Illinois SMP at AgeOptions for help: 
(800)699-9043.
 
Spreading the SMP Message in Your Community

Recently, Cheryl Lockwood of the Northeastern Illinois Area Agency on Aging, one of our SMP partners, gave an SMP presentation to the University of Illinois Extension in Morris, Illinois. Her presentation was part of a workshop that was covered by the Morris Daily Herald (click here for that news article). 

As Cheryl says in the article, "People don't realize how extensive Medicare and insurance fraud is." The truth is that it is happening in every part of and every community in our state. Luckily, the Illinois SMP has partners and volunteers across the state doing outreach and presentations like this one in their own communities. 

If you would like more information about SMP outreach in your community or how you can volunteer to help, please call us at (800)699-9043. A big thank you to Cheryl and all of our partners across the state for the great work you do!

AgeOptions Ideogram

 

Jason B. Echols, MSW,
Health Care Consumer Protection Coordinator
AgeOptions
1048 Lake Street, Suite 300
Oak Park, IL 60301
phone (708)383-0258 fax (708)524-0870
jason.echols@ageoptions.org

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.
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 jason.echols@ageoptions.org.