Friday, August 12, 2016
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In This Issue
 
Fraud in the News
The following are current news articles about health care and fraud issues.

Health Care Fraud:



Consumer Fraud:



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, 

 

This week's Fraud Alert includes tips to know if Medicare is actually contacting you and news of a statewide expansion of the CMS home health moratorium in Illinois.

 

Have a great weekend!

 
The Medicare Current Beneficiary Survey & What to Do if You Think Medicare is Contacting You

Here at the Illinois SMP, we hear from Medicare beneficiaries who are contacted by scammers pretending to be from Medicare. We are often asked if Medicare will ever legitimately contact beneficiaries. There are times the Centers for Medicare & Medicaid Services (CMS), which runs the Medicare program, may contact you, but there are two important things that CMS or Medicare will not do:
  • Medicare or CMS will never call or come to your door without first sending you a letter in the mail explaining why they are trying to contact you.
  • Medicare will never ask for your Medicare number or Social Security number because they already have it.
This fall, CMS is sending a letter to randomly selected Medicare beneficiaries in parts of Illinois and other states inviting them to take part in the Medicare Current Beneficiary Survey (MCBS). The letter sent to this random sample of people explains that a researcher from NORC at the University of Chicago, the CMS contractor conducting the survey, will be contacting them. The letter will include a phone number to call for more information as well as a brochure about the survey.

If you get this letter, remember that participation in the survey is optional. If you do not receive this letter but receive a call or an in-person visit from someone saying that they are from Medicare or NORC, be cautious. Do not share any information or let them in until you verify they are truly who they say they are. You can call the Illinois SMP at AgeOptions (800)699-9043 for help verifying their identity.

You can find out more about the MCBS at mcbs.norc.org. If you receive this letter and want to verify that it is truly from Medicare, you can call us at (800)699-9043 and ask for SMP.
 
CMS Moratorium on New Home Health Agencies is Now Statewide in Illinois

For the past three years, CMS has placed a moratorium (or ban) on new home health agencies becoming Medicare providers in the Chicagoland area. This means that CMS does not allow new home health agencies to get a provider number, which would allow them to bill Medicare. On July 29 of this year, CMS announced that they would expand this ban to all new home health agencies in the state of Illinois for the next six months. This expansion also bans new home health agencies from gaining provider numbers to bill Medicaid and CHIP. Read more about this expansion of the moratorium in this CMS press release.

The goal of the moratorium is to control the number of home health providers and allow law enforcement to focus on controlling fraud, waste, and abuse. Exceptions to the moratorium may be granted if CMS determines that it is restricting access to home health for beneficiaries who actually need that service.

What does this mean for beneficiaries? This should not change how beneficiaries get Medicare's home health services when they are medically necessary. You should only get home health when ordered by your doctor. You should use a Medicare approved home health provider, which you can find by searching on Medicare.gov. To learn more about how Medicare covers home health services, you can read the Illinois SMP's article on home health

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.