Friday, June 26, 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.

Consumer Fraud:

1. "Fortuneteller or Financial Advisor?" (FTC)

2. "Is a Reverse Mortgage Right for You?" (FTC)

3. "Strings Attached to Some 'Risk-Free' Trial Offers" (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. 90MP0216) 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 news of the recent nationwide health care fraud takedown, including the multiple fraud indictments in Illinois.

Have a great weekend!

Nationwide Takedown Charges
243 Individuals with Health Care Fraud Totaling $712 Million in False Billing

On June 18, the U.S. Department of Justice (DOJ) and U.S. Department of Health and Human Services (HHS) announced a nationwide takedown in which 243 individuals were indicted on health care fraud charges. The alleged fraud in these cases totals approximately $712 million in false billing.

For more information, see the following resources:

Click here for the DOJ Press Release
Click here for resources from the HHS Office of Inspector General, including a fact sheet summarizing the charges nationwide

This takedown involved 17 districts across the country, including Northern Illinois and Southern Illinois (see the following two stories in this Fraud Alert for more details).

Over the past several years, the Illinois SMP received consumer complaints about some of the providers involved in these indictments. We hope this news will encourage consumers to continue to report potential fraud because complaints may provide helpful information to law enforcement entities investigating and prosecuting cases such as these. To report potential health care fraud, call the Illinois SMP at AgeOptions (800)699-9043.

Four Medicare Fraud Cases in Chicago Area Announced in National Take Down

Four Chicago-area Medicare fraud cases were announced as part of the recent nationwide health care fraud takedown with 13 individuals indicted. Three of these four cases involved home health fraud. Examples of the alleged fraudulent practices in these cases include falsely certifying Medicare beneficiaries as homebound, paying kickbacks for referral of patients, paying kickbacks to beneficiaries for the use of their Medicare numbers, and falsifying documents to make patients appear sicker than they actually were.

Read more about these cases and the charges filed against the defendants in this U.S. Department of Justice press release (click here).

12 People Indicted in Southern Illinois for Defrauding Medicaid Program as Part of Operation Home Alone IV

As part of the national June 18th health care fraud takedown, the U.S. Attorney's Office for the Southern District of Illinois announced indictments for 12 individuals who defrauded a state Medicaid program that placed personal assistants in the homes of people who needed in-home care. The 12 defendants are charged with submitting bills for personal assistant services that were supposedly medically necessary but were never performed.

These indictments are part the U.S. Attorney's Office's "Operation Home Alone IV" program, the fourth wave of similar indictments in southern Illinois. The first three waves led to 43 indictments.

Read more about these charges and Operation Home Alone IV in this U.S. Department of Justice press release (click 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.