Friday, April 10, 2015

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.

Health Care Fraud:

1. "Physician Charged with Receiving a Kickback" (FTC)

2. "Woman Admits Billing Home Services Program While In Jail" (FTC)

Consumer Fraud:

3. "Social Security Initiative Highlights Zero Tolerance for Fraud" (NCPW)

4. "Reluctant To Be Rude?" (FTC)

5. "Unlocking the Code" (FTC)

6. "The FTC Didn't Send That Sweepstakes Letter" (FTC)

7. "Scammers Play Name Game and Get Caught" (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.

Dear SMP Readers,

This week's Fraud Alert features money recovered by the federal health care fraud program, convictions in a kickback case, and tips for tax return fraud.

Have a great weekend!

$3.3 Billion Recovered Last Fiscal Year by Government Health Care Fraud Program

The Health Care Fraud and Abuse Control (HCFAC) Program is the federal program to prevent and combat health care fraud. In a recently released report, the program recovered $3.3 billion in fiscal year 2014. HCFAC is a joint program between the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ), and since the program began in 1997, it has recovered $27.8 billion.

HCFAC also provides funding to SMP programs nationwide to empower Medicare and Medicaid beneficiaries to prevent, detect, and report health care fraud.

Read more about the money recovered in the last fiscal year and other HCFAC highlights in this HHS press release.

To read the full HHS Office of Inspector General (OIG) report, click here and select the FY 2014 report (national SMP efforts are highlighted on pages 63-65).

Kickback Convictions in Chicago's Sacred Heart Hospital Case

A jury in Chicago recently convicted the former owner and chief executive officer, the chief operating officer, and the chief financial officer of the now-closed Sacred Heart Hospital in Chicago of collectively paying hundreds of thousands of dollars in illegal kickbacks. A kickback is when someone pays a physician in exchange for the referral of Medicare or Medicaid patients. In the case of Sacred Heart, these kickbacks increased the hospital patient count and therefore increased the hospital's revenue from Medicare and Medicaid.

Each defendant was charged with conspiring to violate the federal health care anti-kickback statute along with multiple counts of actually paying kickbacks. Sentencing for these defendants is scheduled for July 2015.

The federal government's work on this case falls under the Medicare Fraud Strike Force in Chicago, part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT) initiative. You can read more in the DOJ's official press release by clicking here.

The Chicago Tribune covered the Sacred Heart Hospital case since the story broke. You can read more about these convictions and find links to past reporting on this story in the article "Ex-Sacred Heart Hospital executives convicted in kickback scheme" on the Chicago Tribune website.

Tax Return Fraud

"Tax Day," the day that individual tax returns are due to the Internal Revenue Service (IRS), is this Wednesday, April 15. On this Tax Day, remember that tax-related fraud can happen throughout the year.

The FBI's Internet Crime Complaint (IC3) recently reported on tax return fraud where criminals steal a person's identity to file a tax return using that person's social security number. These criminals then have the tax refund sent to their address or bank account. Read more on the IC3's website:

http://www.ic3.gov/media/2015/150402.aspx

The IRS also has a "Taxpayer Guide to Identity Theft," which includes tips for preventing fraud, such as checking your credit report regularly for suspicious activity. Read all of the IRS tips by clicking here.

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.