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AJC.com > Metro > View from the cop > Archives > 2006 > March > 27 > Entry
Con artists prey on elderly health care
The Atlanta Journal-Constitution
I like to write about topics that I have covered before for two reasons:
— They remain topical and sometimes you need to hear the same subject more than once.
— I forgot that I wrote it the first time.
But I digress….
Criminals target senior citizens for several reasons. Older American citizens are most likely to have a larger savings, they own their home, have excellent credit and generally are in a better financial position to buy something. This is appealing to a con artist.
People who grew up in the 1930s to 1950s were generally raised to be more trusting of other people. Con artists know that these folks find it more difficult to say no to something.
Another reason older folks are likely targets is that they are more reluctant to report fraud because they don’t know who to report it to and are ashamed of having been scammed.
I worked several “pigeon drops” involving victims who had an idea they were getting conned but were reluctant to say something to either family, friends or the police because they were ashamed and, which makes sense, were afraid that family members would think they no longer had the capacity to take care of their own financial matters.
Compounding the crime directed toward seniors is the fact that many make poor witnesses due to age and memory. Many crooks depend on the victim not being able to provide accurate information to the investigators. Remember, to get these crooks prosecuted, the victim has to provide detailed information as to how many times the con man called, what time the calls were made, call-back numbers and / or addresses left, if the victim met the crook, what he or she looked like, accent, where the money was sent if that was the case, conversation notes, promises made by the crooks, and other information that would require details.
Here are some frauds in the health-care area.
Medical equipment fraud
There are several types of health insurance frauds, including schemes where equipment manufactures offer “free” products to individuals. Insurers are then charged for products that were not needed and/or may not have been delivered.
“Rolling lab” schemes
Unnecessary and sometimes fake tests are given to individuals at health clubs, retirement homes or shopping malls and then billed to insurance companies or Medicare.
Some providers and customers bill insurers for services never rendered by changing bills or submitting fake ones.
Medicare fraud
Medicare fraud can take the form of any of the health insurance frauds described above. Senior citizens are frequent targets of Medicare schemes, especially by medical equipment manufacturers who offer seniors free medical products in exchange for their Medicare numbers.
Because a physician has to sign a form certifying that equipment or testing is needed before Medicare pays for it, conartists fake signatures or bribe corrupt doctors to sign the forms. Once a signature is in place, the manufacturers bill Medicare for merchandise of service that was not needed or ordered.
Tips to avoid health insurance frauds
— Never sign blank insurance claim forms.
— Never give blanket authorization to a medical provider to bill for services rendered.
— Ask your medical providers what they will charge and what you will be expected to pay out-of-pocket.
— Carefully review your insurer’s explanation of the benefits statement. Call you insurer and provider if you have questions.
— Do not do business with door-to-door or telephone salespeople who tell you that services of medical equipment are free.
— Give your insurance / Medicare identification only to those who have provided you with medical services.
— Keep accurate records of all health-care appointments.
— Know if your physician ordered equipment for you.
Counterfeit prescription drugs
— Be mindful of appearance. Closely examine the packaging and lot numbers of prescription drugs and be alert to any changes from one prescription to the next.
— Consult you pharmacist or physician if your prescription drug looks suspicious.
— Alert your pharmacist and physician immediately if your medication causes adverse side effects or if your condition does not improve.
— Use caution when purchasing drugs on the Internet. Do not purchase medications from unlicensed online distributors or those who sell medications without a prescription. Reputable online pharmacies will have a seal of approval called the Verified Internet Pharmacy Practice Sites (VIPPS), provided by the Association of Boards of Pharmacy in the United States.
— Product promotions or cost reductions and other “special deals” may be associated with counterfeit product promotion.
Just be sure to take some time and verify what your physician recommends for you and like everything else, be cautious about shortcuts and things that are too good of a deal.
Comments
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By Jennifer
March 27, 2006 4:59 PM | Link to this
Don’t forget to mention the faith-based con artists. You know, the ones who go door to door and eventually end up asking for money for one reason or another. And the ones who tell you to put your hand on the television in order to be healed, of course, they want money, too.
By Missandie
March 27, 2006 11:30 PM | Link to this
Lt. Steve,
One very important point: Medicare is behind the curve when it comes to protecting SSN numbers. Most of us now, have an system-generated insurance number. The insurance industry began using these system-generated ID numbers due to rising number of identity thefts. Not that long ago, our insurance ID numbers were based on our SSNs. Medicare is still using SSNs as the ID number. So if some unscrupulous person gets ahold of a Medicare number, they will also have that person’s SSN. Be wise!
By Miriam Holland
April 1, 2006 9:51 PM | Link to this
Steve,
Great article.