#USA #Albany #Medicare Fraud #StateWide #hospice care

Medicare Fraud Focus: Hospice Care

Introduction

In August 2025, the New York StateWide Senior Action Council (StateWide) highlighted a pressing issue within Medicare services: hospice care fraud. This initiative is part of their ongoing effort to protect the approximately 2.5 million older adults in New York.

StateWide's commitment is not merely to inform but to empower seniors and their caregivers through the Senior Medicare Patrol (SMP) program, which educates on how to detect, prevent, and report fraud, errors, and abuse related to healthcare and Medicare services.

Understanding Hospice Care

Hospice care plays a crucial role for terminally ill patients by focusing on providing comfort and quality of life rather than curing the illness itself. It includes invaluable services such as medical care, respite care, medications, and durable medical equipment to assist with pain management. Given the sensitive nature of this care, it unfortunately becomes a target for fraudulent activities, particularly scams aimed at the elderly.

Scams Targeting Seniors

Maria Alvarez, the executive director of StateWide, emphasizes the danger posed by con artists targeting older adults under the guise of offering free services. This unscrupulous behavior includes:

• - Door-to-door visits claiming to offer assistance
• - Unsolicited phone calls proposing aid or equipment
• - Text messages and emails leading to fake offers
• - Misleading advertisements that hide their true intentions

These scammers may enroll unsuspecting seniors into hospice care without their knowledge or consent, billing Medicare for unnecessary services.

Warning Signs of Fraud

To safeguard against these fraudulent schemes, seniors should be vigilant and aware of the warning signs, such as:

• - Only licensed physicians can certify a patient for hospice care, typically when the prognosis is six months or less to live.
• - Medicare does not cover unsolicited services like cleaning or kitchen help as part of hospice care.
• - Offering gifts as an incentive for service acceptance is a red flag.
• - Always review Medicare Summary Notices (MSN) or Explanation of Benefits (EOB) to check for unauthorized charges.

Support from Medicare Patrol

The New York SMP is a resource that assists seniors with questions or concerns about fraud, quality of care, or abuse in nursing homes. The council offers trained advisors who can guide beneficiaries in combating Medicare fraud. Seniors can reach out for help by calling 800-333-4374.

Maria Alvarez stresses the importance of education, stating, “We have trained advisors ready to help beneficiaries understand their rights and options in battling healthcare fraud. To report suspected wrongdoing related to Medicare, seniors can contact our New York State Medicare Fraud Hotline at 800-333-4374 or visit www.nysenior.org.”

The Financial Impact of Fraud

According to estimates, Medicare fraud costs American taxpayers over $60 billion each year. This shocking statistic underscores the critical need for vigilance and awareness among seniors, which StateWide aims to foster through their Fraud of the Month program initiated in 2022. Every month, they shed light on various fraudulent tactics that specifically affect the elderly.

Conclusion

As we observe August’s focus on hospice care fraud, it’s essential for seniors and their families to remain informed about potential scams. The fight against this form of exploitation is ongoing, and with resources provided by organizations like StateWide, there is hope for prevention. Education and awareness are the keys to shielding vulnerable individuals from the grasp of fraudulent schemes. Seniors are encouraged to ask questions, seek assistance, and remain skeptical of offers that seem too good to be true. By staying proactive, we can help protect our community’s elders from being victimized.

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For more information on Medicare fraud and to get assistance, seniors can connect with StateWide for ongoing support and education on their rights and available resources.