Posts Tagged ‘fraud’

Medicare Fraud. How We Can Fight it.

Wednesday, September 18th, 2019

Today we bring you a blog post from guest blogger and NJFA friend Charles Clarkson, Project Director of the Senior Medicare Patrol of New Jersey.


By Charles Clarkson, Project Director, Senior Medicare Patrol of NJ

 

Medicare fraud is estimated to cost American taxpayers $60 billion a year, monies that are siphoned off and are not available for legitimate Medicare services. At the Senior Medicare Patrol of NJ (SMP), which is a federally funded program, we want to educate Medicare beneficiaries so they do not become victims of Medicare fraud. There are steps Medicare beneficiaries can take to fight this fraud. The most important step is to protect your Medicare number. Even though Medicare issued new Medicare cards to all beneficiaries with randomly generated numbers and letters and removed the social security number from the cards, the Medicare number (now known as the Medicare Beneficiary Identifier) is still very valuable to fraudsters who can use it to bill Medicare. Beneficiaries should not give out their Medicare numbers to anyone they don’t trust. This is especially true for the many beneficiaries who receive robo calls on a constant basis. The rule of thumb is to never pick up the phone if you do not recognize the telephone number on your message machine. Let the message machine screen all of your calls and then you can decide to return the call or not. Most beneficiaries will find that no message is left and they can then ignore the call.

The next step is to always read your Medicare Summary Notice (MSN), the document a beneficiary receives from Medicare usually 3 months after seeing a Medicare provider. It is important for beneficiaries to review their MSN, not just because of fraud but because mistakes can also happen.

Step three is to keep a personal health care journal or calendar. Record every time you see a medical provider, take a test or have other services provided. When you get your MSN compare it with your journal or calendar. Make sure you are not being scammed. If you are not sure something is fraud or you have a question about the billing, call your provider and ask for an explanation.

Step four is to report any suspected fraud or error. This step is vitally important. Failure to report will translate into the provider getting away with any fraud or errors. Remember, this is your money. You pay Medicare premiums, co-pays, co-insurance, deductibles and other charges. If you need assistance in fighting Medicare fraud, as you were unable to resolve it yourself, call the SMP. Our telephone number is 732-777-1940 and our hot-line number if 877-SMP-4359. A beneficiary can also use our web-site to report a fraud on the form provided. Visit seniormedicarepatrolnj.org

Even if you are not sure if it is fraud but need questions answered, call us. We are a free service and we are here to help. Every beneficiary should feel empowered to help fight Medicare fraud. At the SMP we want to keep Medicare as a viable program that is there for every beneficiary.


Charles Clarkson is Project Director of the Senior Medicare Patrol of NJ

Recent Developments in D.C. To Combat Financial Abuse of the Elderly

Thursday, March 15th, 2018

Recent Developments in D.C. To Combat Financial Abuse of the Elderly

by Robert M. Jaworski, Esq.

Financial abuse of the elderly is getting some attention in Washington these days, and, some say, it’s about time.  On February 22, 2018, Attorney General Jeff Sessions and law enforcement partners announced[1] the largest coordinated sweep of elder fraud cases in history.  In addition, it was reported[2] on March 13, 2018, that an elder fraud bill sponsored by Senate Aging Committee Chairwoman Susan Collins (R-Maine) was recently folded into the banking regulation bill (S. 2155) that is expected to be approved by the Senate in the near future.  Details concerning both of these developments are set forth below.

Nationwide Elder Fraud Sweep Coordinated by the Department of Justice

The cases, which include criminal, civil and forfeiture actions, involve more than 250 defendants from around the globe. They are charged with victimizing more than a million Americans, most of whom are elderly.  Of the defendants, more than 200 have been charged criminally.

The actions charged a variety of fraud schemes, including large scale mass mailing, telemarketing and investment frauds, as well as individual instances of identity theft and theft by guardians.  One case alone concerned a scheme that operated from 14 foreign countries and resulted in losses to American victims totaling more than $30 million.

Mass mailing schemes.  In each of the mass mailing schemes, fraudsters sent direct-mail letters to individuals falsely promising them that they had won cash or other valuable prizes.  All they had to do to claim their prizes was to send back a payment for what was represented as processing fees or taxes. The letters appeared to come from legitimate sources, typically on official-looking letterhead, and to have been personally addressed to each recipient. When an individual took the bait and sent the requested fee, the fraudsters simply kept the money.  No victim ever received a promised prize.  Worse yet, when people showed a susceptibility to these scams, the fraudsters repeatedly targeted and victimized them with other scams.

Other Schemes.  Other examples of elder financial exploitation schemes prosecuted by the Department of Justice include:

  • ‚ÄúLottery phone scams,‚Äù in which callers convince seniors that a large fee or taxes must be paid before one can receive lottery winnings;
  • ‚ÄúGrandparent scams,‚Äù which convince seniors that their grandchildren have been arrested and need bail money;
  • ‚ÄúRomance scams,‚Äù which lull victims to believe that their online paramour needs funds for a U.S. visit or some other purpose;
  • ‚ÄúIRS imposter schemes,‚Äù which defraud victims by posing as IRS agents and claiming that victims owe back taxes; and
  • ‚ÄúGuardianship schemes,‚Äù which siphon seniors‚Äô financial resources into the bank accounts of deceitful relatives or guardians;

The Department of Justice indicates that it has partnered with Senior Corps to educate seniors about these types of scams and prevent further victimization.  Senior Corps is a national service program administered by an independent federal agency, the Corporation for National and Community Service (CNCS).  You can access information on Senior Corps’ efforts to reduce elder fraud by clicking here.  If you suspect that you are a victim of a scam, you can file a report with the Federal Trade Commission by clicking here.  Finally, remember that the best way to avoid becoming a victim of a scam is to be skeptical of anything that sounds too good to be true.  It probably is too good to be true!  Check it out first.

Senator Collins Elder Fraud Bill

This bill, Senate Bill S-223[3], which is called the “Senior$afe Act of 2017,” strives to prevent elder financial abuse by encouraging financial institutions (including credit unions, insurance agencies, banks, investment advisers, and broker-dealers) and their employees to sound an alarm bell whenever they suspect that an elderly person is being financially exploited.  The bill seeks to accomplish this objective by immunizing these institutions and employees from potential liability in any civil or administrative proceeding for disclosing such suspicions.

This immunity, however, is subject to the following conditions:

  • The disclosure is made only to a State or Federal banking or securities regulator, a State insurance regulator, a law enforcement agency, and/or a State or local adult protective services agency.
  • The disclosing employee must be a supervisor or compliance officer employed by the financial institution at the time of the disclosure and have made the disclosure in good faith and with reasonable care.
  • The disclosing employee must have previously received training from the financial institution, appropriate to the employee‚Äôs job responsibilities, concerning (1) how to identify and report suspected exploitation of a senior citizen internally and, as appropriate, to government officials or law enforcement authorities, including common signs that indicate the financial exploitation of a senior citizen, and (2) the need to protect the privacy and respect the integrity of each individual customer of the financial institution.

Interestingly, New Jersey already has a similar law on the books, which dates back to 1998.  The New Jersey Foundation for Aging helped to educate concerned individuals and agencies about that law following its enactment.

 

Mr. Jaworski is a member of the NJFA Board of Trustees and an attorney with the law firm Reed Smith, LLP.  He specializes in providing banks and other financial institutions with advice and assistance concerning their responsibilities to comply with applicable federal and state laws and regulations, including, in particular, consumer protection laws and regulations.

 

 

 

Scammer Lingo

Wednesday, April 5th, 2017

Scammer Lingo

Here on NJFA’s blog we have featured a few posts about scams, we’ve also done articles in Renaissance and posted scam warnings on Social Media. It seems there is always a new scam or the resurgence of an old scam to be on the lookout for.

But that got us thinking… do we really know what all the terms associated with scams mean? The tactics that scammers use come with their own little lingo. In order to be more prepared and aware- we thought, why not share some of the terms most commonly associated with scams? That way you know what we are talking about when you read about a new scam or a warning of a scam to look out for.

Here is a sampling of terms and their definitions.

Pharming:¬†When hackers use malicious programs to route you to their own websites (often convincing look-alikes of well-known sites), even if you’ve correctly typed in the address of the site you want to visit.

Phishing: The act of trying to trick you (often by email) into providing your personal data or credit card numbers, usually a scammer will pose as a trusted business or other entity.

Ransomware:¬†A malicious program that restricts or disables your computer, hijacks and encrypts files, and then demands a fee to restore your computer’s functionality.

Scareware: A program that displays on-screen warnings of nonexistent infections on your computer to trick you into installing malware or buying fake antivirus protection.

Skimming:¬†The capture of information from the magnetic strip on credit and debit cards by using a¬†“skimmer” devices. These skimmers are secretly installed on card-reading systems at gas pumps, ATMs and store checkout counters.

Spoofing:¬†Scammers can use technology to pose as a specific person, business or agency, this technology allows them to manipulate a telephone’s caller ID to display a false name or number, so that it appears they are calling from a legitimate business or from a local number.

Spyware: A type of malware installed on your computer or cellphone to track your actions and collect information without your knowledge.

As a reminder, if you have been the victim of a scam, contact your local Police Department and/or the Federal Trade Commission  https://www.ftccomplaintassistant.gov/#crnt&panel1-1  or the NJ Division of Consumer Affairs 1-800-242-5846 or www.njconsumeraffairs.gov  

 

The New Medicare Cards

Wednesday, February 8th, 2017

The New Medicare Cards

By Charles Clarkson, Project Director, Senior Medicare Patrol of New Jersey

In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act. This law requires the removal of the social security numbers from all Medicare cards by April 2019. This new initiative is referred to as the Social Security Number Removal Initiative (SSNRI.) A new randomly generated Medicare Beneficiary Identifier (MBI) will replace the social security number. When the initiative gets underway all Medicare beneficiaries will be assigned a new MBI and be sent a new Medicare card.

The primary goal of the initiative is to decrease Medicare beneficiaries’ vulnerability to identity theft by removing the social security number from their Medicare cards and replacing it with a new Medicare MBI which does not contain any other personal information.

The new MBI will have the following characteristics:

i. The same number of characters as the current Medicare number, but will be visibly distinguishable from the Medicare number

ii. Contain uppercase alphabetic and numeric characters throughout the new MBI

iii. For providers, the new MBI will occupy the same field as the Medicare number on transactions

iv. Be unique to each beneficiary (e.g. husband and wife will have their own MBI)

v. Be easy to read and limit the possibility of letters being interpreted as numbers (e.g. alphabetic characters are upper case only and will exclude S, L, O, I, B, Z)

vi. Not contain any embedded intelligence or special characters

vii. Not contain inappropriate combinations of numbers or strings that may be offensive

The Centers for Medicare and Medicaid Services (CMS), the agency that oversees Medicare, has established a transition period during which the Medicare number or MBI will be accepted from providers, beneficiaries, plans, and others. CMS expects the transition period to run from April 2018 through December 31, 2019. After the transition period only the MBI will be used.

Starting around April 2018, CMS will start mailing new Medicare cards. There are approximately 60 million beneficiaries in Medicare. So, CMS will probably mail the cards in phases over a period of time. Remember, as a beneficiary you can still use your current Medicare number during the transition period if it takes awhile to receive your new Medicare card. If a beneficiary is new to Medicare after April 2018 and Medicare has started issuing the new cards, the beneficiary will receive the new MBI. Therefore, healthcare providers must be able accept the new MBIs by April 2018.

Fraud and the new Medicare cards.

The Senior Medicare Patrol of New Jersey (SMP) wants all Medicare beneficiaries to be aware of possible fraud and scams relating to the new Medicare cards. Remember, CMS and Medicare will never contact you by phone or email to ask for personal information relating to the issuance of the new Medicare cards. Any such contact is a scam. Don’t be taken in. Also, there will be no charge for the issuance of the new Medicare cards. Anyone seeking to have a beneficiary pay money for the new card is a scammer. Be especially careful of anyone seeking to have access to your checking account to pay any fee for the new card. Beneficiaries are especially vulnerable if they are isolated, frail or may have cognitive loss. Caregivers should be on the alert for these kinds of scams. The SMP is currently educating beneficiaries at its outreach events of the issuance of the new Medicare cards. CMS will also be conducting intensive education and outreach to beneficiaries to help them prepare for this change.

The issuance of the new Medicare card is a significant change. If a beneficiary or caregiver has any questions about the SSNRI, please don‚Äôt hesitate to call the SMP at 1-877-SMP-4359 (1-877-767-4359) or 732-777-1940. A beneficiary or caregiver can also email me at [email protected].

Phone Scams

Tuesday, January 31st, 2017

Here are NJFA, we like to make sure we are keeping folks aware of scams and fraud issues. Our February episode of Aging Insights, is titled, Stop Identity Theft and features two guests that will help viewers to protect themselves. We also want to address a scam that’s been in the news.

Recently, news outlets across the United States reported on a new scam referred to as the “can you hear me?” telephone scam. According to those¬†reports, the scam begins with an unsolicited phone call. After the caller makes contact they ask the recipient “Can you hear me?” to elicit a response of “yes,” and a potential onslaught of unauthorized charges ensues.

The story goes that if you get this call and respond “yes” to the question, “can you hear me?” that the scammer could be recording it and could use it against you. There is the possibility that you could receive a bill for something you did not purchase or agree to and when you go to dispute the bill you will be presented with your own voice saying “yes” on the recording.

The first thing we want to warn readers about is if you don’t know the caller or are suspicious of their intent, you should always hang up. Do not give personal information or engage the caller in conversation if you have doubts about the legitimacy of the call. You should also contact the appropriate authority to report any issues or to verify any information you are given on the call. For example, if the caller claims to be from your utility company, call the # on your monthly statement to verify your account status or any issues.

After some additional research, we‚Äôd also like you to know what some investigators have discovered about this scam. According to the fact-finding website, Snopes, ‚Äúwe haven’t yet been able to identify any scenario under which a scammer could authorize charges in another person’s name simply by possessing a voice recording of that person saying “yes,” without also already possessing a good deal of personal and account information for that person, and without being able to reproduce any other form of verbal response from that person.‚Äù That doesn‚Äôt mean it cannot happen, just that the reports thus far only support the threat and not any actual monetary charges.

The Snopes article adds, ‚ÄúIn all the news reports we found, interviewees¬†merely¬†reported¬†having been asked the common question (“Can you hear me?”) but did not state that they themselves had fallen prey to scammers.‚Äù

That being said, we still advice you to use caution when receiving unsolicited phone calls, hanging up is ok. And if you have any scams or crimes to report, contact your local police, the Federal Trade Commission (www.ftc.gov/complaint or 1-877-438-4338), and/or your local Better Business Bureau.

 

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