Friday, August 3, 2018
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Fraud in the News
The following are current news articles about fraud issues.

Consumer Fraud:

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This project was supported, in part by grant number 90MP0216, 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. 

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Dear SMP Readers, 

In this week's Fraud Alert, Rex receives his new Medicare card, and news about four local physicians charged in the nation's largest health care fraud takedown. 

Have a good weekend!

Look What Rex Got!
Rex_ a plastic pill-bottle figure_ with his new Medicare card.

Rex lives in Anywhere, Illinois and recently received his new Medicare card! While having lunch at his local congregate meal site, Rex learned from a SMP volunteer what steps he should take after receiving his new Medicare card.

Start to use your new card right away. Take it with you to your next appointment.

Safely and securely destroy your old Medicare card; you will no longer need it. Your old card most likely has your Social Security number on it, and if it were lost or stolen, your identity could be stolen. One of the main reasons for receiving a new Medicare card was to remove your Social Security number in order to help prevent identity theft.

Guard your new card as you would a credit card. While your new Medicare card will have a randomly-generated Medicare number unique to you, it is still important to protect that number. Scammers are good at tricking people into giving them personal information, and if you give them your new Medicare number, they can falsely bill your Medicare account for services or supplies you never receive. Only give your Medicare number to health care providers you know and trust.

Continue to use your other insurance cards. If you have Medicare Advantage, Medicare Part D, Medicaid,  HealthChoice Illinois, or a Medicare Supplement continue to use those cards for your health care needs or when you pick up prescriptions at the pharmacy. 

If you have questions about the new Medicare card, feel free to reach out to the Illinois SMP at AgeOptions at (800)699-9043.

Four Area Doctors Face Charges in Nation's Largest Health Care Fraud Takedown  

The Department of Justice recently announced its largest ever health care fraud takedown in history where 601 defendants across 58 federal districts were charged for the alleged participation in health care fraud schemes involving more than $2 billion in false billings. Several Chicago-area medical professionals, including four doctors were charged as part of the investigation. 

Two of the Chicago-area cases involved physicians who allegedly falsified documentation and certified patients for home health services reimbursed by Medicare. 
Another Chicago-area case involved a physician who allegedly earned over $5.5 million by falsely billing both Medicare and Medicaid for psychotherapy services that were never performed.  A fourth case involved a physician who owned two home-visiting physician companies and allegedly billed Medicare for more than  $2.8 million of unnecessary and "up-coded" home-physicians visits between 2010 and 2018.

Read more in this U.S. Department of Justice press release.  As a reminder, charges are merely allegations, and all defendants are presumed innocent until proven guilty. 
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