On a podcast, the SMP director talks about SMP; the numbers of Medicare beneficiaries; the size of Medicare losses; examples of beneficiary cases; how to look at Medicare statements; what to do if you believe there is an error in billing; and the benefits of volunteering with SMP. She also discusses the value of prevention. Listen to and read a story from KHON.

Volunteers at two Senior Health Insurance Information Program and Senior Medicare Patrol sponsor sites have been recognized as Best in State at helping clients find financial assistance to cover Medicare costs and avoid Medicare fraud, scams, and abuse. The Medicare Improvements for Patients and Providers Award celebrates a site where volunteers prioritize screening clients about their income and assets to identify eligibility for financial assistance covering Part B premiums and drug costs. Read a story from the Southeast Iowa Union.

While passing the potatoes, bring up how we can protect ourselves and our loved ones from being deceived. Scams to talk about include phone scams and mail and online scams. If you need help reading your Medicare Summary Notice or Explanation of Benefits or need a My Health Care Tracker, call the SMP. Read a story from CNHI News.

The Nebraska Department of Insurance (NDOI) is warning about Medicare insurance scammers claiming to be from the Nebraska State Health Insurance Assistance Program (SHIP) and Senior Medicare Patrol (SMP), a division of the NDOI. The NDOI reminds Nebraskans that it does not sell Medicare insurance and will never contact you asking for personal or payment information. Read a story from NewsRadio 1040 WHO.

During Open Enrollment, Maria Alvarez of the Senior Action Council of New York/SMP said it’s important to double check what your plan covers against what Medicare Advantage plans offer because gaps of coverage are created minute to minute. Seniors should also prepare themselves for possible scams. They need to safeguard their information in the event deceptive telemarketers might be calling. Read a story from WAER.

Kevin Karl Wills Jr. pleaded guilty to conspiring to receive kickbacks in return for referring Medicare beneficiaries for COVID-19 tests and for purchasing and selling Medicare beneficiary identification numbers. According to a plea agreement, Wills and a co-conspirator introduced marketers to medical service providers, and the marketers agreed to supply the providers with lists of Medicare beneficiaries and their identifying information. The providers then shipped COVID-19 tests to the beneficiaries and billed Medicare for the tests. Click here to read more.

Osman Syed, also known as Syed Osman, the owner and operator of BioDX Labs LLC, was charged in connection with his role in a $79 million respiratory pathogen panel (RPP) testing fraud scheme where the tests were not provided and were medically unnecessary. According to court documents, Osman used the personal identifying information of a physician, without the physician’s knowledge or consent, to cause the submission of millions of dollars in claims to Medicare and Medicaid for RPP tests for beneficiaries and recipients, even though the physician had no prior relationship with them, was not treating them for respiratory symptoms, and did not use the tests to treat them. Click here to read more.

An indictment says sober home company Serenity Keepers allegedly used urine drug tests for clients for nonmedical reasons, such as ensuring sobriety. It alleges that its owner solicited kickbacks from a co-conspirator in exchange for the referral of Serenity Keepers’ urine drug tests to various laboratories. It also alleges that the urine drug tests performed for Serenity Keepers’ clients were not used for medical diagnosis and treatment, nor were they ordered by a treating medical provider, which are requirements for reimbursement by Medicare and Medicaid. Click here to read more.

Criminal convictions and civil settlements have been announced against a second wave of doctors who participated in nationwide telemedicine fraud schemes by ordering medically unnecessary orthotic braces and genetic testing, allegedly wasting Medicare dollars to line their own pockets. These actions follow nationwide takedowns of so-called “marketers” and owners of medical supply companies and genetic testing laboratories who worked together to conduct large-scale schemes to defraud Medicare. Federal investigators initiated these investigations based on a detailed review of Medicare data relating to expensive braces and genetic tests, which sometimes exceed $8,000 per test. Click here to read more.