Friday, October 2, 2015

In This Issue

Medicare's Annual Open Enrollment Begins October 15

Free Back Brace Scam

Pay to Win?

Fraud in the News

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

Health Care Fraud:

1. "West Suburban Doctor Pleads Guilty to Causing $4 Million Loss to Medicare by Falsely Approving Unnecessary Treatment" (DOJ)

2. "Three Family Members In A Wheeling Chiropractic Group Indicted For Phony Billing And Unnecessary Treatment In $10.8 Million Fraud Scheme" (DOJ)

3. "Former Owner of Edgewater Medical Center Pleads Guilty to Perjury for Willfully Impeding Efforts to Collect $188 Million in Civil Judgments" (DOJ)

Consumer Fraud:

4. "Fla-Grant Lies" (FTC)

5. "Scam-Spotting Help for Recent Refugees" (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 a reminder about Medicare's open enrollment, an article about a back brace scam, and an alert about prize scams. Check out our Fraud in the News section on the left for news about health care fraud indictments and guilty pleas.

Have a great weekend!

Medicare's Annual Open Enrollment Begins October 15

October 15 to December 7 is Medicare's annual open enrollment period, a time in which Medicare beneficiaries can review their coverage options, including Part D, for the next year (2016). Everyone is encouraged to review their coverage. You may have started a new drug this year or your current plan may have changed their drug formulary. You can compare your current plan to other 2016 plans by visiting the Plan Finder at www.Medicare.gov or find a SHIP counselor near you by calling your local area agency on aging (www.eldercare.gov).

During open enrollment, you may meet with insurance agents trying to sell plans. Medicare has strict rules on how agents can sell Medicare plans, and while most agents follow these rules, it is important to know that you should never feel pressured into buying a plan.

The Illinois SMP has more information about open enrollment and insurance marketing scams in this article (click here). If you are meeting with an agent, you may want to download our "Ask the Right Questions" form (click here) to make sure you are getting all the information about the plans you are considering.

Free Back Brace Scam

A recent Los Angeles Times article "Healthcare watch: How to avoid becoming a victim of Medicare fraud" (click here) highlights a durable medical equipment scam that happened in California. A woman responded to an ad for a free back brace and gave the company her Medicare number. The problem in responding to ads or cold calls offering free equipment is that the are often medically unnecessary and could prevent you from getting a benefit when you need. The article highlights the work of the California SMP in educating consumers about fraud in that state.

We often see this type of scam in Illinois. As the article points out, the California SMP helps people file reports to Medicare about potential fraud. If you are in Illinois, call the SMP at AgeOptions (800)699-9043.

Did you know there is an SMP in every state? Find your state's SMP at www.smpresource.org. Congratulations to the California SMP and their volunteers for being featured in this article!

Pay to Win?

SMP recently received a call from the resident services coordinator at a senior building in Illinois. Several of the building's residents were getting calls from a company saying that they had won a sweepstakes... but they first had to pay $400 to claim their prize. The caller claimed to be calling from a company with a name similar to a popular national sweepstakes. Luckily, some residents thought this was suspicious and talked to their resident coordinator before sending any money.

Sweepstakes Scams (or Prize Scams) lure people in with the promise of winning big bucks, but it is important to remember that you should never have to pay to claim a prize. The Federal Trade Commission has great information about Prize Scams, including tips to recognize, avoid, and report this scam, in this article (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.