SMP
Senior Medicare Patrol
CARE SHARE
Telehealth and COVID-19 Fraud
Telehealth fraud is rampant in Montana. The complaints Montana Senior Medicare Patrol (MT SMP) have received are not the local providers who may conduct telehealth consults. Rather it is through unsolicited phone calls people are receiving with the purpose of sending you unnecessary supplies or to steal your medical identity.
The callers may not come out and tell you exactly what they are calling for, but the result will be in your receiving unnecessary testing kits or durable medical equipment. The most common type reported to MT SMP right now has been cardiac genetic tests. Often the caller either already has your Medicare number and information, or they trick you into giving them the missing pieces by telling you they need to confirm it.
Paying for unnecessary supplies and tests is a large part of the $60 million Medicare loses to fraud, waste and abuse each year in Montana. Nationwide that number is closer to $70 billion. According to a recent article written by the DC SMP, a woman from Georgia and her accomplices admitted to committing a telemedicine kickback scheme in which she recruited physicians and medical professionals to authorize orders for durable medical equipment and genetic testing.
The defendant claimed to have recruited nurses to contact patients to conduct telemedicine visits. Consequently, she also had access to patients’ sensitive medical records. She processed thousands of fraudulent orders of medical supplies, such as orthotics, braces, pain creams, and genetic testing kits, which her co-conspirators billed to Medicare and Medicaid.
This is a common method that has occurred in Montana as well. If you don’t know who you are speaking to and they are inquiring about your medical needs, please hang up and consider consulting with your own provider if you have needs that aren’t being met.
If you know of someone or if you yourself have been a victim of telehealth fraud, received unnecessary genetic testing kits or durable medical equipment in the mail, or have given out your information, please call your local MT SMP at 1-800-551-3191.
Source: https://www.justice.gov/usao-sdga/pr/georgia-woman-admits-participation-scheme-obtain-fraudulent-reimbursements-medical
Montana SMP is a program coordinated by Missoula Aging Services and partnered with local Area Agencies on Aging. This project was supported by grant #90MPPG0052 from the U.S. Administration for Community Living, Department of Health and Human Services, Washington D.C., 20201. Points of view or opinions do not necessarily represent official ACL policy.
TELEHEALTH FRAUD PREVENTION TIPS
- Telehealth services include virtual office visits, psychotherapy, and certain medical services using 2-way telecommunication systems like video, telephone, or email. With the growth in Telehealth, fraudulent activities have also increased. GUARD YOUR PERSONAL INFORMATION If you receive a call from someone you don’t know claiming to be a medical professional and they request your personal information, don’t provide it until you
check with your primary care physician to ensure the request is valid. - LOOK OUT FOR SUSPICIOUS CHARGES If someone informs you that 100% of the cost of a telehealth appointment will be covered by Medicare, check-in with your provider to make sure you know what services
are covered and review your Medicare Summary Notice for improper billing of items or services. - BE LEERY OF FREE OFFERS If you are informed that you can submit an electronic payment or your credit card
information in exchange for free medical/lab testing kits, free telehealth services, free durable medical equipment, or a free coronavirus emergency kit, HANG UP. It is a SCAM. - KEEP TRACK OF YOUR MEDICAL APPOINTMENTS To help mitigate telehealth fraud, write down all your medical appointments to include the physician or facility’s name and date of service and then compare with what is listed on your Medicare Summary Notice. SMP’s can provide you with a Personal Healthcare Tracker for this purpose. Call MT SMP at 1-800-551-3191 for a free copy.
- IF YOU SUSPECT TELEHELATH FRAUD, ADDRESS IT IMMEDIATELY Report potential telehealth fraud if:
- You receive an unsolicited phone call from someone wanting to verify your pain
symptoms - You receive an unsolicited phone call from someone wanting to verify your family
history or medical illnesses including cardiovascular, genetics, or any cancer
GET HELP FROM SENIOR MEDICARE PATROL (SMP) IF YOU NEED ASSISTANCE
1-800-551-3191
The Senior Medicare Patrol (SMP) helps to educate Medicare beneficiaries about ways to prevent, detect, and combat Medicare Fraud. For more information about Medicare Fraud, visit the Stop Medicare Fraud website at https://www.stopmedicarefraud.org