Fight against Medicare fraud needs your help

With increasing sophistication, scammers are bilking the elderly and Medicare out of billions of dollars a year. Such fraud cost the government $47 billion in 2008 and with the rise in use of high-tech billing that figure could climb.

In early December, 26 people in three cities, including a Florida doctor, were busted for pilfering $61 million from Medicare through fraudulent billing schemes. The investigation was due to the formation in May of a strike force that combined the efforts of the U.S. Justice and Health and Human Services departments.

Both health care reform bills commit significant dollars to pursuing fraud. President Obama has already pledged more enforcement support to HHS in the 2010 budget. Cutting costs is key to helping pay for proposed health care reforms that would expand coverage. Cracking down on fraud is a key component of that.

Beyond these governmental efforts, there are 4,700 citizen volunteers who do valuable work in ferreting out fraud that targets the elderly. The Senior Elderly Patrol operates in all 50 states and has been credited with saving the government $100 million since 1997. So this is more than seniors helping seniors.

While the patrol cannot arrest people or otherwise enforce laws, it provides an invaluable service by informing the government on where it needs to direct its efforts.

“There is no substitute for beneficiaries and on-the-ground resources to help us know where fraud is occurring and where problems are arising,” Kimberly Brandt of the Centers for Medicare and Medicaid Services told the Associated Press.

The elderly provide a tempting target, because they have health care coverage and have accumulated savings over their lifetimes. Also, many senior citizens live alone and aren’t computer savvy.

The Washington state attorney general’s office has good advice on its Web site for seniors who use the Internet. Among the tips: Don’t use an e-mail link to a purported government agency. It could be a fake site. Use a search engine to find the official site. Never give out personal information in response to an e-mail. Never believe that someone wants to give you money or anything for free.

As for Medicare scams, make sure to check your health care statements to make sure there isn’t a billing for devices or drugs you haven’t ordered. Be aware of double-billing, too. If someone shows up at the door after you’ve gotten home from the hospital, be suspicious. You might be asked to purchase something that the government won’t cover or has already paid for.

Whether you have fallen for a scam or not, be sure to report it. Yes, it can be embarrassing, but there’s no point in letting others get scammed and letting the culprits get away with it.

An aggressive crackdown on Medicare fraud is long overdue, but there is no force as effective as citizens armed with skepticism and awareness.