Thursday, May 2, 2019

Medicare Fraud: Red Flags to Avoid

I serve on the Advisory Committee of the Senior Medicare Patrol of New Jersey. SMP-NJ receives federal funding to prevent and investigate Medicare fraud. Below are three types of fraud that were discussed at a recent meeting:

¨      Medical Brace Scams- A health care fraud involving $1.2 billion in fraudulent payments for medical braces was recently shut down. Beneficiaries are urged to contact Medicare authorities if they receive unneeded durable medical equipment purportedly ordered by doctors that they have never seen. Call 1-800-MEDICARE as soon as possible to report a scam.


¨ Phone Call Scams- The best defense against phone calls by fraudsters is to not answer the telephone if you have caller ID and do not recognize the number. Instead, let your answering machine pick up the call and delete messages that do not come from legitimate callers. Another option is to use call-blocking services such as Nomorobo and Hiya.


¨ DNA Testing Scams- “Free DNA testing” is another scam being directed against Medicare recipients. Following the popularity of services that provide DNA testing for people to discover their family background, fraudulent companies are touting DNA tests to Medicare beneficiaries as a “preventative service.” In reality, Medicare will pay for genetic tests only in very limited circumstances.


If you see something, say something. Medicare fraud costs taxpayers millions of dollars each year. SMP-NJ director Charles Clarkson noted that, if beneficiaries and/or their caregivers do not report scams such as those noted above, Medicare has less money to pay legitimate claims.

Every American has a stake in fighting Medicare fraud.

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