Categorized | Technology

How you can stop Medicare fraud



Depending on which side of the aisle you sit on, the future of Medicare either looks grim or promising as its fiscal strength shows signs of improvement despite the program being constantly under siege by fraudsters.

In Congress, there has been talks for years now to either phase out the medical insurance program that benefits nearly 58 million Americans, the vast majority seniors, or possibly even privatize it.

Medicare, established in 1966, is big business as it has grown to a $600 billion annual government expense with it projected to grow even higher as the nation’s senior population continues to rise. By 2030, there will be about 79 million Americans enrolled in the program, according to the Centers for Medicare and Medicaid Services.

But Medicare suffers $60 billion a year in fraud, one of our nation’s greatest downfalls, as the program is abused at seemingly every possible level whether it’s doctors, pharmacists or standard scam artists who specialize in identity theft.

Fortunately, the U.S. Department of Justice takes these crimes very seriously, as proven by a July 13 announcement that it charged more than 400 individuals across the country in a major crackdown on health care fraud. The suspects cost the federal government $1.3 billion in false Medicare and Medicaid billing, according to the DOJ.

The investigation is part of an effort to stem opioid abuse, which is starting to take a greater toll on our aging population.

Despite these efforts, people age 65 or older are increasingly victimized by identity theft, often through their Medicare identification cards. Between 2012 and 2014, the numbers of seniors whose identity was stolen leaped from 2.1 million to 2.6 million, according to the DOJ.

It’s no wonder, considering Medicare cards are 10 times more valuable on the black market than credit cards because they currently contain members’ Social Security numbers.

To combat abuse, the CMS is readying a fraud prevention initiative that removes Social Security numbers from the cards in favor of unique, randomly assigned numbers. New cards will be issued starting in April with a goal to transition all members to the new cards by April 2019.

In the meantime, however, fraudsters are salivating over the transition as it will give them the opportunity over the next 19 months to rip off the identities of millions of seniors.

In California, the state’s 24 Health Insurance Counseling and Advocacy Programs are prepping to launch an education campaign about the new ID cards.

HICAP and Senior Medicare Patrol warn that fraudsters are ready to take to the phones to scam seniors.

They caution that crooks pretending to be from Medicare or Social Security may phone asking to verify Social Security numbers, birth dates and addresses so that enrollees can get their new cards and not lose benefits or be delayed in receiving services.

Don’t fall for it, they warn, because Medicare, Social Security or the Internal Revenue Service will never cold call you.

HICAP, a nonprofit, provides free and objective information and counseling about Medicare.

The trouble is, HICAP has suffered from a loss of funding and is largely a volunteer-driven organization. In March, the White House administration’s proposed budget nearly wipes out funding for the State Health Insurance Assistance Program, which funds 24 HICAP offices in the state.

As HICAP prepares for this transition, it is doing so with extremely limited resources. It’s a recipe for disaster.

HICAP is the first line of defense against preventing fraud and identity theft against seniors. It must not fail.

So, what do we do? Can we help?

Of course. It’s simple really. You can either donate money to keep HICAP afloat or you can even volunteer for the organization. There are multiple offices all over the Bay Area to contact if you are interested in protecting seniors and protecting Medicare, which is a sacred program for millions of Americans.

Stopping fraud should start with us. We shouldn’t let our older Americans fall prey to scam artists with the transition to new Medicare cards.

If we want Medicare to survive for generations, we need to tackle the problem together.

I urge you to join this endeavor because, after all, it’s your future health care that’s at risk.

David J. Canepa serves on the San Mateo County Board of Supervisors representing District 5 and is the former mayor of Daly City.

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