Protect yourself against Medicare/Medicaid fraud

By Russ Van Arsdale, Executive Director, Northeast CONTACT
Posted March 09, 2013, at 2:45 p.m.

State and federal officials paid a visit to Bangor last week to educate seniors about the fraud problem in the Medicare and Medicaid systems. The FBI estimates the cost to taxpayers at $60 billion to $80 billion annually.

There’s a big price for those crimes, and we all pay. As Raymond Hurd, Acting Regional Administrator for the Centers for Medicare and Medicaid Services, said last week in Bangor, federal officials recovered four billion dollars in fraudulently obtained funds last year. But crooks are getting away with many billions more, and exactly how much is subject to various estimates.

“Fraud is fairly pervasive,” said Michael Miller, director of the Healthcare Crimes Unit of the Maine Office of the Attorney General since 2007. Miller is heading up a working group that’s reviewing policies and practices — including the ways health care providers are enrolled in the federal systems — with an eye toward curbing fraud.

Hurd and Miller were members of a panel at the Hammond Street Senior Center Wednesday. Also on the panel were Susan Waddell, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General, Office of Investigations for the Northeast; and Betty Balderston, Maine Coordinator of the Senior Medicare Patrol. BDN Reporter Nick McCrea wrote about the meeting, but the messages on fraud prevention bear repeating.

Panelists agreed that consumers make up the first line of defense in fighting Medicare and Medicaid fraud. They advised seniors to guard their Medicare numbers (which, in many cases, are the same as a recipient’s Social Security number and are therefore a draw for identity thieves). They also advised that seniors call their healthcare providers in cases of questionable billing items, especially when such “billing errors” happen repeatedly.

In an interview, Balderston offered these tips for seniors to avoid becoming victims:

  1. Never provide your Medicare or MaineCare numbers, bank account numbers or any other personal information to someone you don’t know who calls you on the phone or sends you an email.
  2. Review your Medicare statements. Make sure the services and supplies that Medicare paid for were services and supplies you actually received. Use a Personal Health Journal to record your services, supplies and medications. Booklets are free from your local Area Agency on Aging.
  3. When you have a question about anything your health care provider billed to Medicare, MaineCare or other insurance, call your health care provider.
  4. If you believe your Medicare number has been used to commit fraud, contact 1-800-Medicare. If you believe your MaineCare number has been used to commit fraud, contact the MaineCare Fraud Control Unit at the Maine Attorney General’s Office at 207-626-8870. If you need assistance making a complaint, contact the Maine Senior Medicare Patrol at your local Area Agency on Aging at 1-877-353-3771.

An investigation in the news recently involves allegations that one or more manufacturers of power scooters are ripping off Medicare; that investigation is ongoing.

You might be eligible for a reward of up to $1,000 if you report an instance of fraud that is verified. Visit www.stopmedicarefraud.gov for details.

Remember, every dollar scammed from Medicare or Medicaid is a buck that can’t be spent on real health care needs. And that’s a crime.

Consumer Forum is a collaboration of the Bangor Daily News and Northeast CONTACT, Maine’s all-volunteer, nonprofit consumer organization. For assistance with consumer-related issues, including consumer fraud and identity theft, or for information, write Consumer Forum, P.O. Box 486, Brewer 04412, visit http://necontact.wordpress.com or email contacexdir@live.com.

http://bangordailynews.com/2013/03/09/business/protect-yourself-against-medicaremedicaid-fraud/ printed on August 28, 2014