Fraud Alerts Contain Information About Current Scams Taking Place in Illinois, Announcements s1

FRAUD ALERT

Friday, August 1, 2014

Please share this Fraud Dear SMP readers, Alert with colleagues, consumers, or other This week’s Fraud Alert contains news of an arrest in Cook County for professionals in your area. If Medicare fraud, an indictment in southern Illinois of telemarketers, and you have any questions the story of Illinois couple scammed by an IRS imposter. about the Illinois SMP program, or to receive these Have a great weekend! Fraud Alerts directly, please contact Jason Echols, What you will find in this week’s Fraud Alert Healthcare Consumer  Doctor at Home Manager Arrested on Fraud Charges Protection Coordinator at  Drug Discount Telemarketing Scammers Charged in Illinois AgeOptions.  Rockford Couple Lost $1,000 to Continuing IRS Scam

This document was supported in Doctor at Home Manager Arrested on Fraud Charges part by a grant (No. 90MP0163 & 90SP0061) from the On July 29, a registered nurse in who managed Doctor at Home, a Administration on Aging (AoA), company in Schaumburg, Illinois that sends physicians to patients’ Administration for Community homes, was arrested on Medicare fraud charges. These charges include Living (ACL), U.S. Department of falsely submitting claim codes to receive a higher payment from Health and Human Services Medicare (upcoding), double-billing Medicare for a single visit, and billing (DHHS). Grantees carrying out projects under government for medically unnecessary tests. One of the allegations in this charge is sponsorship are encouraged to that the company was certifying patients for home health care even express freely their findings and though the patients were not homebound, a requirement for Medicare- conclusions. Therefore, points of covered home health services. In a recorded conversation, the defendant view or opinions do not allegedly encouraged a physician to be an “artist” and “paint the picture” necessarily represent official AoA, ACL, or DHHS policy. of each patient who did not qualify for services in a way that Medicare would accept the claims. Fraud In The News The following are current Read more about these charges in this U.S. Department of Justice press news articles about health release: http://www.justice.gov/usao/iln/pr/chicago/2014/pr0729_01.html care and fraud issues. A complaint is not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial. Health Care Fraud: 1. “CMS Extends Moratoria Drug Discount Telemarketing Scammers Charged in Illinois for Newly Enrolling In East St. Louis, Illinois, a grand jury indicted three Canadian citizens Ground Ambulance with defrauding older Americans. The defendants own and operate a Suppliers & Home Health telemarketing business that allegedly called Americans, and while Agencies” (CMS): implying that they were affiliated with federal government programs, such http://cms.hhs.gov/Newsro as Medicare, led consumers to believe they needed to purchase a om/MediaReleaseDatabas prescription drug discount card in order to keep their Medicare or social e/Press-releases/2014- security benefits. The telemarketers would take bank information and Press-releases- charge a fee, usually $299, for these discount cards, which are available for free online. For most beneficiaries with Medicare Part D prescription items/2014-07-29.html drug plans, the discount cards have little or no benefit. More than 5,000 Americans were defrauded in this scam, including seven in southern Consumer Fraud: Illinois. Read more in this U.S. Department of Justice press release: 2. “Another AARP Spoofing http://www.justice.gov/usao/ils/News/2014/Jul/07242014_Sebai Scam Surfaces” (AARP): %20Press%20Release.html. An indictment is not evidence of guilt. The http://blog.aarp.org/2014/0 defendants are presumed innocent and are entitled to a fair trial. 7/25/another-aarp- spoofing-scam-surfaces/ This $299 or $399 prescription drug discount scam has been around for several years. If you are having trouble paying for prescriptions, you can 3. “Fraud Alert: New Fraud get help comparing Part D plans or see if you qualify for programs to Scheme Targeting help with drug costs by calling your local area agency on aging. Find Families of your local senior service agency at www.eldercare.gov. Unaccompanied Children” (HHS OIG): Rockford Couple Lost $1,000 to Continuing IRS Scam http://oig.hhs.gov/fraud/co The following Chicago Tribune article “Scammers posing as Treasury nsumer- officials who threaten arrest if not paid” presents the story of a Rockford, alerts/alerts/targeted- Illinois couple who lost $1,000 to a scam artist who called posing as an children.asp IRS official. Read the full article here: http://www.chicagotribune.com/news/local/ct-arrest-warrant-scam-met- 4. “How to Say Scram to 20140709,0,4830192.story Crammed Charges on Your Mobile Bill” (FTC): Scams like this are part of what the Treasury Inspector General for http://www.consumer.ftc.g Taxpayer Administration has called this the “largest scam of its kind that ov/blog/how-say-scram- we have ever seen,” and the scam continues to happen across the crammed-charges-your- country with new twists. In a recent AARP article, Sid Kirchheimer mobile-bill explains some of these twists and includes tips for avoiding this scam. Read the full AARP article here: http://blog.aarp.org/2014/07/11/tax-