FRAUD ALERT
Friday, August 1, 2014
Please share this Fraud Alert
with colleagues, consumers,
or other professionals in your
area. If you have any
questions about the Illinois
SMP program, or to receive
these Fraud Alerts directly,
please contact Jason
Echols, Healthcare
Consumer Protection
Coordinator at AgeOptions.
This document was supported in
part by a grant (No. 90MP0163 &
90SP0061) from the
Administration on Aging (AoA),
Administration for Community
Living (ACL), U.S. Department of
Health and Human Services
(DHHS). Grantees carrying out
projects under government
sponsorship are encouraged to
express freely their findings and
conclusions. Therefore, points of
view or opinions do not necessarily
represent official AoA, ACL, or
DHHS policy.
Fraud In The News
The following are current
news articles about health
care and fraud issues.
Health Care Fraud:
1. “CMS Extends Moratoria
for Newly Enrolling
Ground Ambulance
Suppliers & Home Health
Agencies” (CMS):
http://cms.hhs.gov/Newsro
om/MediaReleaseDatabas
e/Press-releases/2014Press-releasesitems/2014-07-29.html
Dear SMP readers,
This week’s Fraud Alert contains news of an arrest in Cook County for
Medicare fraud, an indictment in southern Illinois of telemarketers, and
the story of Illinois couple scammed by an IRS imposter.
Have a great weekend!
What you will find in this week’s Fraud Alert
 Doctor at Home Manager Arrested on Fraud Charges
 Drug Discount Telemarketing Scammers Charged in Illinois
 Rockford Couple Lost $1,000 to Continuing IRS Scam
Doctor at Home Manager Arrested on Fraud Charges
On July 29, a registered nurse in who managed Doctor at Home, a
company in Schaumburg, Illinois that sends physicians to patients’
homes, was arrested on Medicare fraud charges. These charges include
falsely submitting claim codes to receive a higher payment from
Medicare (upcoding), double-billing Medicare for a single visit, and billing
for medically unnecessary tests. One of the allegations in this charge is
that the company was certifying patients for home health care even
though the patients were not homebound, a requirement for Medicarecovered home health services. In a recorded conversation, the defendant
allegedly encouraged a physician to be an “artist” and “paint the picture”
of each patient who did not qualify for services in a way that Medicare
would accept the claims.
Read more about these charges in this U.S. Department of Justice press
release: http://www.justice.gov/usao/iln/pr/chicago/2014/pr0729_01.html
A complaint is not evidence of guilt. The defendant is presumed innocent
and is entitled to a fair trial.
Drug Discount Telemarketing Scammers Charged in Illinois
In East St. Louis, Illinois, a grand jury indicted three Canadian citizens
with defrauding older Americans. The defendants own and operate a
telemarketing business that allegedly called Americans, and while
implying that they were affiliated with federal government programs, such
as Medicare, led consumers to believe they needed to purchase a
prescription drug discount card in order to keep their Medicare or social
security benefits. The telemarketers would take bank information and
charge a fee, usually $299, for these discount cards, which are available
for free online. For most beneficiaries with Medicare Part D prescription
Consumer Fraud:
2. “Another AARP Spoofing
Scam Surfaces” (AARP):
http://blog.aarp.org/2014/0
7/25/another-aarpspoofing-scam-surfaces/
3. “Fraud Alert: New Fraud
Scheme Targeting
Families of
Unaccompanied Children”
(HHS OIG):
http://oig.hhs.gov/fraud/co
nsumeralerts/alerts/targetedchildren.asp
4. “How to Say Scram to
Crammed Charges on
Your Mobile Bill” (FTC):
http://www.consumer.ftc.g
ov/blog/how-say-scramcrammed-charges-yourmobile-bill
drug plans, the discount cards have little or no benefit. More than 5,000
Americans were defrauded in this scam, including seven in southern
Illinois. Read more in this U.S. Department of Justice press release:
http://www.justice.gov/usao/ils/News/2014/Jul/07242014_Sebai%20Pres
s%20Release.html. An indictment is not evidence of guilt. The
defendants are presumed innocent and are entitled to a fair trial.
This $299 or $399 prescription drug discount scam has been around for
several years. If you are having trouble paying for prescriptions, you can
get help comparing Part D plans or see if you qualify for programs to
help with drug costs by calling your local area agency on aging. Find
your local senior service agency at www.eldercare.gov.
Rockford Couple Lost $1,000 to Continuing IRS Scam
The following Chicago Tribune article “Scammers posing as Treasury
officials who threaten arrest if not paid” presents the story of a Rockford,
Illinois couple who lost $1,000 to a scam artist who called posing as an
IRS official. Read the full article here:
http://www.chicagotribune.com/news/local/ct-arrest-warrant-scam-met20140709,0,4830192.story
Scams like this are part of what the Treasury Inspector General for
Taxpayer Administration has called this the “largest scam of its kind that
we have ever seen,” and the scam continues to happen across the
country with new twists. In a recent AARP article, Sid Kirchheimer
explains some of these twists and includes tips for avoiding this scam.
Read the full AARP article here: http://blog.aarp.org/2014/07/11/taxscammers-up-ante-with-robocalls/
Remember that the IRS or other government agencies never call to
demand payment. If you receive these calls, hang up and call the IRS.
Jason B. Echols, MSW, Health Care Consumer Protection Coordinator
AgeOptions
1048 Lake Street, Suite 300
Oak Park, IL 60301
phone (708)383-0258 fax (708)524-0870
jason.echols@ageoptions.org
ageoptions.org
AgeOptions, the Area Agency on Aging of Suburban Cook County, is
committed to improving the quality of life and maintaining the dignity of
older adults and those who care about them – through leadership and
support, community partnerships, comprehensive services, accurate
information and powerful advocacy.
Fraud Alerts contain information about current scams taking place in Illinois, announcements and updates
about programs or services related to health care and/or fraud protection, and links to news articles about
health care and fraud topics. Please forward any recommendations or announcements that you would like to
be included in a future Fraud Alert to jason.echols@ageoptions.org.