Friday, June 5, 2015

In This Issue

Fraud in the News

Fraud Doesn't Pay: 75 Months of Jail Time for Medicare Fraudster in Illinois

Psychologist Pleads Guilty to Medicare Fraud in Chicago

AARP Article Highlights Changing Nature of Medicare Fraud

Fraud in the News

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

Health Care Fraud:

1. "Durable Medical Equipment Suppliers to Pay $7.5 Million to Resolve False Claims Act Allegations" (DOJ)

Consumer Fraud:

2. "Older Adults Get Into the Act Online" (FTC)

3. "Social Security's Death File Aids in ID Theft" (AARP)

4. "Shutting Down a Sweepstakes Scam that Sought Out Seniors" (FTC)

5. "Consumer Advisory: Don't Be Misled by Reverse Mortgage Advertising" (CFPB)

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 has news of court action in two fraud cases in the Chicago area, including jail time for one fraudulent provider. There is also an AARP article on Medicare fraud scams.

Have a great weekend!

Fraud Doesn't Pay: 75 Months of Jail Time for Medicare Fraudster in Illinois

This week, the former owner of a Chicago-area physical and respiratory therapy service company was sentenced to 75 months in prison for his role in a health care fraud scheme. He was also ordered to repay the more than $2.5 million he gained from defrauding Medicare and Blue Cross Blue Shield of Illinois. The fraud occurred in 2011 when the provider submitted claims for services that were never provided.

Read more about this sentencing in the U.S. Department of Justice press release by clicking here.

This story highlights the importance of reading your Medicare Summary Notice (MSN) to look for services that you never received. If you find something that you believe is an error on your MSN, call the Illinois SMP at (800)699-9043. To learn more about reading your MSN, read our tip sheet here.

Psychologist Pleads Guilty to Medicare Fraud in Chicago

A Chicago area psychologist pleaded guilty to one count of health care fraud last week for submitting thousands of false claims to Medicare for services to beneficiaries in skilled nursing homes. While she was claiming to provide services, fraud investigators found that she was actually inflating the number of service hours (sometimes billing for more than 24 hours in a day), claiming that she provided services on a certain day even though she was in another city, and submitting claims for beneficiaries who were already deceased.

Read more about this case in the U.S. Department of Justice press release by clicking here.

AARP Article Highlights Changing Nature of Medicare Fraud

A recent AARP Bulletin article titled "New Medicare Scams Spread Across U.S." highlights current Medicare scams across the country. The article also explains how fraud patterns can change as scammers adapt to changing circumstances. Read the full article on the AARP website, by clicking here.

This article also features quotes from a Texas SMP volunteer.

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.