Cases: January 1-February 21, 2020 47 cases total 14 12 10 8 13 - - PowerPoint PPT Presentation

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Cases: January 1-February 21, 2020 47 cases total 14 12 10 8 13 - - PowerPoint PPT Presentation

Mar 01, 2024 303 likes •404 views

Cases: January 1-February 21, 2020 47 cases total 14 12 10 8 13 6 10 4 8 7 2 3 3 1 0 1 1 0 BILLING ISSUES DECEPTIVE DECEPTIVE DME BRACE FRAUDULENT MEDICARE MEDICARE MEDICARE PHONE SCAMS MISC. HOME HEALTH HOSPICE SCAMS

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8 1 10 13 7 1 1 3 3

2 4 6 8 10 12 14 BILLING ISSUES DECEPTIVE HOME HEALTH CARE ENROLLMENTS DECEPTIVE HOSPICE ENROLLMENTS DME BRACE SCAMS FRAUDULENT GENETIC TESTS MEDICARE ADVANTAGE PLANS AND AGENTS MEDICARE CARD PHONE SCAMS MEDICARE SUPPLEMENT SCAMS PHONE SCAMS MISC.

Cases: January 1-February 21, 2020

47 cases total

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  • Seniors respond to robo call or TV ad
  • Disclose Medicare #
  • Receive boxes and boxes of medical

equipment

Medicare Back Brace Complaints

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MSN showing brace claims submitted to Medicare:

  • Negative impacts:
  • False claims billed.
  • No access to needed

DME.

  • Compromised Medicare

number.

  • More scam calls.
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SLIDE 4
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SLIDE 5

Hospice Complaints

  • 5. VISA

Assistance

  • 2. Free

DME, Shakes Transportation

  • 1. Free

Cooking & Cleaning

  • 4. Hospice

Claim

  • 3. Age

Qualified

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  • An agent enrolled a beneficiary into

a plan without their permission.

  • Agent changed the scope of appt.
  • Agent offers free trips, meals in

return for signing up.

  • Agent misrepresents the plans

benefits.

  • Agent tells beneficiary they have to

sign up or they will lose their Medicare.

Neg egative tive imp mpact acts: s:

  • Medicare may stop

paying claims.

  • No access to see

PCP and/or specialists.

  • Medical bills.
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SM SMP Fr Frau aud Ale lerts ar are avail ailable le in in 9 9 lan languages Fr Free downloads at t Calif alifornia ia Healt alth Advocates: https://cahealthadvocates.org/fraud-abuse/medicare-fraud-alerts/

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California Senior Medicare Patrol

www.cahealthadvocates.org 855-613-7080

  • Medicare education and advocacy

California Health Advocates (501C3)

  • On site fraud prevention presentations
  • Fraud alerts
  • eNewsletter
  • Fraudulent billing help and referrals
  • Monthly educational webinars
  • Preventing Active Shooters & Workplace

Violence in Healthcare

  • Center for Medicare Advocacy (March 26)

Senior Medicare Patrol Program