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The Cost of Medicare Fraud

Numerous changes in healthcare laws over the past several years have left an opening for fraudsters to take advantage of seniors in creative ways.

Published: May 12, 2015

The Cost of Medicare Fraud

Numerous changes in healthcare laws over the past several years have left an opening for fraudsters to take advantage of seniors in creative ways. Confusion regarding the Affordable Care Act’s (ACA) impact on Medicare initially created a deluge of new scams. While more seniors are now more familiar with the ACA, crooks are still twisting facts about the law, as well as taking advantage of confusion over Medicare in general, to bilk Medicare, and the seniors themselves, out of millions of dollars annually. Medicare Fraud

While it is difficult to assess the precise dollar amount, the United States Government Accountability Office estimates that fraudulent charges reached about $50 million in 2013. The schemes are so profitable, in fact, that some drug dealers are switching from selling illegal drugs to submitting fraudulent prescription claims using stolen Medicare and social security numbers, a much safer and equally lucrative trade.

Seniors and their families can take action to protect themselves and their savings. They can start by becoming aware of the latest scams. The number of scams is extraordinary, encompassing fraudulent enrollments in the ACA and unnecessary or fake tests given to seniors to “free” supplies for diabetics and counterfeit prescription drugs. The Federal Bureau of Investigation and U.S. government have a number of comprehensive pages detailing the latest cons as well as information on where to report suspected fraud (see the references below).

However, since fraud is so rampant, and the government has difficulty keeping pace, seniors themselves are taking matters in their own hands by forming “Senior Medicare Patrols.” Senior Medicare patrols are made up of seniors who work to educate and protect other seniors from fraud. Each state has programs to help local seniors, and the national Senior Medicare Patrol website has resources for detecting and preventing fraud as well as contact information for reporting suspected fraud. They also help victims of suspected fraud identify and report fraud to the appropriate authorities.

Families can also help protect their senior loved ones by staying in touch, knowing what is going on medically with their loved ones, and being aware of any information seniors are providing to third parties. In the event that the family is unable to spend sufficient time with the senior, enlisting the aid of an in-home caregiver can help them keep tabs on the senior’s status. Having someone in the home watching out for the senior can help reduce the risk that he or she will become victim of a scam. For more information on how in-home care can help keep your senior loved ones safe, contact your nearest Comfort Keepers® today. 

References

The Economist. (May 31, 2014). The $272 billion swindle. Retrieved from http://www.economist.com/news/united-states/21603078-why-thieves-love-americas-health-care-system-272-billion-swindle.

Federal Bureau of Investigation. (n.d.). Fraud target: Senior citizens. Retrieved from http://www.fbi.gov/scams-safety/fraud/seniors.

Medicare.gov. (n.d.). Report fraud & abuse. Retrieved from http://www.medicare.gov/forms-help-and-resources/report-fraud-and-abuse/fraud-and-abuse.html.

Senior Medicare Patrols. (n.d.). FAQs. Retrieved from http://www.smpresource.org/Content/FAQs.aspx.

Senior Medicare Patrols. (n.d.). Report fraud. Retrieved from http://www.smpresource.org/Content/You-Can-Help/Report-Fraud.aspx.

USA.gov. (February 6, 2015). Consumer protection for seniors. Retrieved from http://www.usa.gov/Topics/Seniors/Consumer.shtml.

United States Government Accountability Office. (April 30, 2014). Progress made, but more action needed to address Medicare fraud, waste, and abuse. Retrieved from  http://www.gao.gov/assets/670/662845.pdf.

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