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Medicare fraud costs taxpayers billions

October 6, 2009 12:00:00 AM PDT
Medicare fraud is now one of the fastest growing crimes in Southern California.Medicare fraud costs taxpayers billions of dollars every year. It is now one of the fastest growing crimes in Southern California. It is a scam that puts patients and doctors at risk while offering a big payoff for the criminal.

"They'll bill Medicare for a back brace for hundreds of dollars, when in fact they could pick it up at your local drug store for like, $20, $30," said Special Agent Glenn Ferry.

Ferry is the special agent in charge with the U.S. Department of Health and Human Services for the Los Angeles region.

Many medical items were confiscated during investigations into Medicare fraud, including electric wheelchairs costing $5,000 each.

Medicare fraud is a multi-billion-dollar illegal business costing each and every one of us.

"Taxpayers are paying for this," said Ferry. "Medicare is paying for this, the patients -- everybody pays for Medicare fraud."

More often than not the elderly victims of Medicare fraud don't even know it's happening until it's too late. Senior centers, like one in Santa Ana, say up to 50 percent of the seniors there get approached.

"We've had seniors approached outside our center or sometimes they come in here, letting them know they can get a free electrical chair ... shoes, you name it," said Rocio Meza, coordinator for a senior center.

Rodolfo Mendoza lives in Santa Ana. He said he was approached at a bus stop by a woman who said she could help streamline his Medicare benefits for him. Because she spoke Spanish and said the right things, he trusted her. A few weeks later an electric wheelchair showed up at his door.

Later his Medicare statement showed a charge of more than $6,000 to the federal government.

Mendoza has no need for an electric wheelchair. He sent it back.

"When Medicare notices that somebody's having a lot of services, it's called 'overutilization,' and Medicare will stop paying on that person," said attorney Julie Schoen.

Schoen is an attorney with the Council on Aging. She says the elderly are usually approached in very public places and unknowingly become a pawn in the fraud game.

"If you go to a health fair and they're promising you free services and they say to you, 'But I'll need your Medicare number first' -- why? It's free. They want your Meidcare number so they can bill Medicare," said Schoen.

There are several ways to defraud Medicare, but here are some ways to prevent it from happening to you:

  • Don't ever give out your Medicare health insurance claim number to anyone but your physician. It's like your Social Security number.
  • Be cautious of anyone who says they have been endorsed by the federal government or Medicare.
  • Avoid anyone who tells you their health care item or service is not usually covered, but they know how to bill Medicare to get it paid.

Even though no money came out of Mendoza's pocket, the fraudster still has his Medicare claim number and can continue to use it to commit fraud.


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