Friday, January 8, 2016

In This Issue

New Year's Resolution to be Fraud Free in 2016

Chicago Area Doctor Sentenced to Two Years in Federal Prison for Home Health Fraud

Fraud & Kickback Indictments Brought Against a Home Health Owner and a Marketer

Fraud in the News

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

Health Care Fraud:

1. "Marion Man Pleads Guilty to Health Care Fraud Charges" (FBI)

Consumer Fraud:

2. "Top Scams of 2015" (AARP)

3. "Top 10 Consumer Protection Blog Posts of the Year" (FTC)

4. "'Brain training' with Lumosity - Does It Really Work?" (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,

Happy New Year! In this first issue of 2016, we have a resolution to be fraud free and two stories about recent law enforcement actions, including jail time for a health care fraudster.

Have a great weekend!

New Year's Resolution to be Fraud Free in 2016

At the beginning of a new year, many people make resolutions. Why not resolve to be health care fraud free in 2016?

This year, become an empowered health care consumer by pledging to making the following three resolutions:

I will not give my Medicare number out over the phone or to someone who is not my trusted doctor or health care provider.
I will read my Medicare Summary Notice (MSN) or Explanation of Benefits, making sure that everything billed to Medicare or my insurance is accurate and reflects the services I received (check out our tip sheet on How to Read an MSN).
If I see something suspicious on my MSN or believe that I've been targeted for fraud, I will call the Illinois SMP at AgeOptions (800)699-9043.

As for how to protect yourself from other scams in 2016, AARP's Sid Kirchheimer recently blogged about this topic and provided some tips. Read more in the post "Scam-Proof 2016 With These 7 Simple Steps" on the AARP blog.

Chicago Area Doctor Sentenced to Two Years in Federal Prison for Home Health Fraud

A doctor in the West Suburbs of Chicago was sentenced to two years in federal prison for his role in falsely approving home health services for individuals who are not homebound. Read more in this Department of Justice press release.

To receive Medicare-approved home health services, a beneficiary must be certified as "homebound" and in need of services in their home. You can read more about how someone would qualify for home health and how to protect against fraud in the SMP Home Health Infograph.

Fraud & Kickback Indictments Brought Against a Home Health Owner and a Marketer

A Chicago area home health owner and an outside marketer have been indicted in a fraud and kickback scheme. The home health owner is accused of paying for home health referrals while the marketer is accused of allegedly accepting payment for referring patients to this home health company. Read more in this Department of Justice press release.

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.