April 22, 2019
$1.2 Billion Medicare Fraud Indictments
As we have discussed in past Fraud Alerts, Durable Medical Equipment (DME) fraud is one the biggest scams we see in Illinois. Earlier this month, the Office of Inspector General with the help of the FBI, IRS, and other federal agencies announced federal indictments against individuals allegedly involved in DME fraud. Additionally, the Center for Medicare Services (CMS) took action against 130 medical equipment companies.

According to these indictments, international call centers were used to up-sell or give "free" braces to beneficiaries regardless if they needed them. These call centers then allegedly gave kickbacks to telemedicine companies for the DME orders. The telemedicine companies then would allegedly pay doctors to write medically unnecessary DME orders. Doctors are needed to sign off on the orders in order for Medicare to pay for the braces.

You can read the whole article and more details about this scam and indictments from the U.S. Department of Justice here.

Remember, Medicare will never call you, and you should only give your Medicare card number out to your doctors or providers. If you have received one of these phone calls and have given out any information, you can report this with the Illinois SMP at AgeOptions at (800)699-9043.
CBS 2 Chicago Features Local Illinois Residents Targeted by DME Fraud in Light of $1.2 Billion Scam
This report from CBS 2 Chicago, showcases the stories of two beneficiaries in Illinois whose Medicare accounts were billed for braces that they did not need. CBS 2 Chicago aired this story when they reported the recent federal indictments, you can read the whole story  here.

This scam begins with a phone call from someone who takes your Medicare number. The company then has doctors sign off on the prescriptions and bill Medicare for braces. Sometimes you may receive braces or other equipment in the mail, but sometimes you may receive nothing.

You can watch the original CBS 2 Chicago story that ran in October 2018 here.
Egyptian Area Agency Educates Older Adults on Healthcare Fraud
Rindi Reeves, our local SMP Partner at Egyptian Area Agency on Aging in Carterville, Illinois, was featured in the Harrisburg Register Newspaper for one of her SMP Presentations at a local library. She provided attendees with a packet of SMP material and tip sheets to help educate them on potential healthcare fraud.

You can read the article here.

Rindi is one of our many statewide SMP partners doing outreach in their local areas. AgeOptions partners with Area Agencies on Aging (AAA) throughout Illinois. In addition to providing SMP outreach, AAAs also provide local assistance to older adults in their area.

Find your AAA at www.eldercare.gov.
Have a wonderful week!

Travis Trumitch
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This project was supported, in part by grant number 90MPPG0036, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.
The Illinois SMP at AgeOptions partners with agencies across the state to empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education.

Please share this Fraud Alert with colleagues, consumers, or other professionals in your area and visit our website to sign up for our Fraud Alert email list.