Friday, February 19, 2016
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In This Issue
 
Fraud in the News
The following are current news articles about health care and fraud issues.




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 project was supported, in part by grant number 90MP0216, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy. 
  

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Dear SMP Readers, 

 

In this week's Fraud Alert, a former hospice owner pleads guilty to fraud charges, the FTC warns about phony health insurance calls and the HHS OIG talks about how they investigate Part D fraud.

 

Have a great weekend!

 
Hospice Owner in Illinois Pleads Guilty to $7 Million Medicare Fraud Scheme

This week, the founder of the now closed Passages Hospice pled guilty to submitting false claims to Medicare for medically unneccessary hospice. According the plea agreement, these false claims included billing for hospice services when the patient was not terminally ill and billing for inpatient care when patients did not require or receive that level of care. Read more in the ABC7 news story "Passages Hospice owner, nursing director plead guilty to $7M health fraud," which includes a link to the plea agreement (click here).

Medicare's hospice benefit is meant for beneficiaries who are terminally ill, meaning that if the illness were to run its normal course, the person is not expected to live more than six months. This may be a very vulnerable time for beneficiaries and their families, and unfortunately, it is a time where fraud may occur. If you believe that Medicare fraud is happening to you or your loved one, you can call the Illinois SMP at AgeOptions, (800)699-9043. 
 
Get a Call About Health Care Insurance Fine? Don't Press One

The Federal Trade Commission (FTC) recently highlighted a robocall phishing scheme on its blog (click here). Here is how the scheme works: You receive a call with a recorded voice that tells you that you need to buy health insurance or else you will have to pay a fine. You are then told to press one for more information.

In this scheme, pressing one or any button does two things. First, it tells the robocaller that there is a live person at this phone number, and you will get more calls like this. Second, it connects you to a scammer that wants to "verify" your personal information, like your social security number. 

This scam plays on the fact that some people without health care insurance are required to pay a fee or a penalty on their taxes. If you are on Medicare or Medicaid, you have health insurance already and do not pay this fee. More importantly, if you owe this fee, it is calculated in your tax return. You will not receive a call about it. If you need help filing your taxes, find your local senior service agency at www.eldercare.gov. Call your local agency to ask about free tax preparation services in your area.
 
Video Highlights Medicare Part D Fraud Investigations

The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) investigates fraud in federal health care programs, including Medicare. In their new video "Eye on Oversight: Medicare Part D Fraud," the OIG highlights its work investigating prescription drug fraud and diversion. Drug diversion is the illegal distribution of prescription drugs or the use of drugs for unintended purposes. Learn more about the HHS OIG's response to this type of fraud in their new video (click here).

Eye on Oversight: Medicare Part D Fraud
Eye on Oversight: Medicare Part D Fraud

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.