#United States #Albany #Medicare Fraud #hospice care #New York StateWide

Understanding Hospice Care Fraud

The New York StateWide Senior Action Council (StateWide) has announced its focus for the month of August, highlighting the critical issue of hospice care fraud within Medicare. This initiative aims to educate elderly citizens on potential fraud schemes and how to protect themselves. With over 2.5 million senior citizens in New York, the council's commitment over its 53 years of operation is to enhance the welfare and safety of this vulnerable population.

What is Hospice Care?

Hospice care provides essential support for individuals who are terminally ill. Unlike traditional medical care that focuses on curing diseases, hospice care emphasizes comfort and enhances the quality of life for patients nearing the end of their journey. This type of care may include services from doctors, equipment for pain alleviation, and respite for families.

The Threat of Scams

Unfortunately, the rise of healthcare fraud, particularly in programs designed to assist the elderly, has led to alarmingly common scams targeting this population. Maria Alvarez, the Executive Director of StateWide, warns seniors about deceptive practices concerning hospice care, which can leave them unsuspecting victims of fraud.

"Scammers often approach older adults with offers of free assistance," states Alvarez. These includes services such as cooking, cleaning, or in-home help, which may seem beneficial at first but can lead to unforeseen threats. Behind these seemingly harmless offers, scammers may enroll individuals in hospice care without their consent, subsequently billing Medicare for unnecessary or non-existent services.

How Scammers Operate

Scammers utilize various methods to reach seniors:

• - Door-to-door visits: They come directly to homes, presenting themselves as caregivers or service providers.
• - Unsolicited phone calls: Creating a false sense of urgency, they often impersonate health professionals.
• - Text messages and emails: Using tailored messages that can appear legitimate to deceive individuals.
• - False advertising: Crafting misleading advertisements that promise services that are actually invalid.

Such tactics can easily ensnare unsuspecting individuals who may not recognize the warning signs of fraud.

Recognizing the Warning Signs

To protect themselves, seniors should remain vigilant and aware of the characteristics of hospice fraud:

• - Doctor certification: Only a medically qualified professional can certify a patient for hospice services, required for those expected to have 6 months or less to live.
• - No free services: Medicare will never cover the costs of free services like cleaning or grooming in exchange for enrollment.
• - Gifts for services: Seniors should never accept gifts linked to services, as these can often mask ulterior intentions.
• - Reviewing documents: Regularly reviewing Medicare Summary Notices (MSN) or Explanation of Benefits (EOB) is crucial to spot unauthorized charges.

Assistance for Seniors

The New York State Senior Medicare Patrol stands ready to offer help. This includes support for questions or complaints related to nursing home services, quality of care issues, or suspected fraud. Certified counselors at StateWide are available to assist seniors, ensuring they're informed and equipped to handle questions related to Medicare and its provisions. For assistance, individuals can reach out at 800-333-4374.

Alvarez emphasizes education as a pivotal strategy in combating fraud, stating, "We have trained counselors to educate Medicare beneficiaries about their rights and the means to prevent healthcare fraud. If anyone suspects Medicare fraud or abuse, they can report it by calling 800-333-4374 or visiting our website at www.nysenior.org."

The Cost of Fraud

Estimates suggest that Medicare fraud costs taxpayers over $60 billion annually across the United States. The Senior Action Council launched this Fraud of the Month campaign in 2022 to shine a light on various scams and to actively engage public awareness on the critical subject of healthcare fraud targeting seniors.

As New Yorkers continue to navigate the complexities of healthcare, staying informed and vigilant against unscrupulous practices in hospice care is paramount. Together, we must foster a safer environment for our older adults and preserve their dignity and health against the threat of fraud.