Healthcare and Medicare Fraud Prevention

SENIOR MEDICARE PATROL

Baltimore County's Senior Medicare Patrol (SMP) is an anti healthcare fraud project. Every year, health care fraud, waste, abuse and error results in the loss of billions of senior and taxpayer dollars. Examples include:

• Giving false or misleading information that benefits the health provider or service but increases consumer costs
• Billing for Medicare or Medicaid services, medicine, equipment or supplies not prescribed, not provided or not needed
• Offering cash, free services, or gift rewards to influence use of a particular doctor, insurance plan, HMO, home health agency, nursing home or other medical services
• Providing care or service that is below accepted standards
• Stopping insurance coverage or ending services without prior notice or reasonable cause

SMP enlists senior volunteers to teach Medicare and Medicaid clients how to recognize and report health care fraud, waste, abuse or error through:

• Counseling to individuals who believe they may have experienced health care fraud in one of its many forms
• Community presentations to educate seniors about how to deter, detect and defend against health care fraud
• Training of volunteers to provide the above individual counseling and community presentations

HOW TO AVOID SCAMS AND FRAUD

PROTECT YOUR MEDICARE CARD

• Medicare will never:
  • Contact you for your Medicare number or other personal information unless you have given them permission in advance
  • Call you to sell anything
  • Visit you at your home
• You may get calls from people promising you things if you give them your Medicare number. Don't do it.
• Medicare can't enroll you over the phone unless you called first.

LEARN HOW TO SPOT FRAUD

Review your Medicare claims and Medicare Summary Notices for any services billed to your Medicare number that you don't recognize. Beware of any and all unsolicited offers. Many will say "free" and then you receive a bill. Never give out personal information to someone you do not know.

ATTEND AN EDUCATIONAL PRESENTATION 

A 45-minute Healthcare Fraud and Abuse Prevention presentation teaches attendees how to spot deceptive health care practices, identity scams, avoid becoming a target of healthcare fraud, and how to recognize and report billing errors.

REPORT ANYTHING SUSPICIOUS 

If you suspect fraud, waste, abuse or error, call 1-800-MEDICARE (1-800-633-4227) or contact your local SMP office at 410-887-2059 or medicareinformation@baltimorecountymd.gov. If you need to replace your card because it is damaged or lost, log into or create your secure Medicare account to print an official copy of your Medicare card. You can also use your account to access your Medicare information anytime, add prescription drugs to help you find and compare health and drug plans in your area, and more.

WATCH OUT FOR ACTIVE SCAMS

PHONE SCAMS

Scams that are currently prevalent in the County include cold callers strongly suggesting:

• Medicare wants you to have a "free" back, neck or knee brace.
• They know you have cardiac problems, therefore you would benefit from having a cardiac genetic test mailed to your home. They may even do a follow-up call to make sure you send the kit back to the lab.

COVID-19 VACCINE FRAUD

Identifying and avoiding fraudulent COVID-19 vaccination cards:

• If you post a selfie showing your completed vaccination card, scammers can use the data such as vaccine type, lot number, etc., for a fake card.
• On eBay and through social media, you can find "authentic" CDC Vaccination Cards for approximately $10 each.
• By combining the "authentic" cards with the vaccine type and lot number, the fraudulent cards will look very real.
• Completed cards can be used artificially as proof of vaccination, placing others at risk of illness and potential death.
• The FBI has warned that anyone who makes a fake vaccine card is breaking the law and would be considered for prosecution.

What you need to know:

• Medicare covers the COVID-19 vaccine, so there will be no cost to you.
• You will need to share your Medicare card with your health provider or pharmacy when receiving your vaccine, even if you are enrolled in a Medicare Advantage Plan.
• If anyone else asks you to share your Medicare number or pay for access to the vaccine, you can bet it's a scam.
• You can't pay to get your name on a list to get the vaccine.
• You can't pay to gain early access to a vaccine.
• Don't share your personal or financial information if someone calls, texts or emails you promising access to the vaccine for a fee.