Beware Medical Medicare Health Care Fraud in North Carolina AARP Bulletin

Beware Medical Medicare Health Care Fraud in North Carolina AARP Bulletin

Beware: Medical, Medicare, Health Care Fraud in North Carolina - AARP Bulletin Scams & Fraud

Beware Medical Fraud

Attend a Scam Jam and learn how you can avoid medical fraud

Stephanie Bias takes medical fraud personally. It's not just that Bias, 55, works as the coordinator for , which is housed within the state's Department of Insurance. She experienced a scam. In early 2007, shortly after her mother's death the previous year, Bias, of Raleigh, was at her mom's house in North Carolina when the phone rang. Thinking she was talking to Bias' 77-year-old mother, the caller asked for her number and and secondary insurance information. The caller promised "our doctor" would certify her for an electric wheelchair.

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That is when the exchange crossed the line, Bias said. "Having a physician other than my mother's personal physician certify need without examining her is fraud. And it's also fraud to solicit insurance information for the purposes of billing for something that's not needed." Bias, who was already affiliated with the patrol, reported the scam to Medicare, but nothing came of it. Medical fraud is widespread, and it's not just targeted at those covered by Medicare. "Age doesn't matter," Bias said. "Everyone is a target when it comes to health care fraud." Medical identity theft is the fastest-growing form of identity theft, which is outpacing all other crimes in America, according to the , a Washington, D.C.- based nonprofit whose members include consumers, insurance companies, legislators and regulators. Helen Savage, associate state director, has been in the business of consumer education and protection for nearly 30 years. She's seen scams become more sophisticated. "The circumstances under which consumer fraud and health care fraud occur now involve technology that can challenge even those with great faith in their ability to spot a scam," she said. Computers can seamlessly alter medical documents. Thieves mine websites for user information or purchase enough information about individuals to steal their identities, set up accounts and make health-care-related purchases in their name. To educate the public, AARP North Carolina participates in Scam Jams, sponsored by state Council on Aging offices in each county. The jams inform older residents about scams aimed at them and how to recognize, avoid and report them or call for help. Fighting health care fraud has become a federal and state priority. The estimates that costs taxpayers $60 billion a year. The General Assembly voted last year to add 25 positions in the department, nearly doubling its size. "People are coming to realize it's more cost-effective to be more proactive about fraud," said , D. His office has recovered more than $360 million in -related fraud over the past 10 years. "Clearly, medical fraud is a significant and underreported problem that ultimately affects consumers of health care everywhere," he said. The federal health care law added $350 million nationwide to combat health care fraud over the coming decade. , including the one Bias heads in North Carolina, have received more federal money to fight health care fraud through education and prevention programs. North Carolina received $300,000. You can help stop medical fraud by following these tips: Track your medical procedures and the purchase of medical equipment in a journal; Monitor credit reports, medical records and the explanation of benefits forms sent by health insurers; Immediately correct inaccurate records; File a police report to let law enforcement know a crime may have been committed, and send a copy to insurers, medical providers and credit bureaus, and Notify the Federal Trade Commission if the problem is one related to medical by calling 1-877-IDTHEFT (438-4338) toll-free.
Lisa H. Towle is head of Liskar Communications and a freelance writer based in Cary, N.C. Cancel You are leaving AARP.org and going to the website of our trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP.org to learn more about other benefits. Your email address is now confirmed. You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. You can also by updating your account at anytime. You will be asked to register or log in. Cancel Offer Details Disclosures

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