FRAUD ALERT
Friday, October 5, 2012
Please share this Fraud Alert
with colleagues, consumers,
or other professionals in your
area. If you have any
questions about the Illinois
SMP program, or to receive
these Fraud Alerts directly,
please contact Jason
Echols, Healthcare
Consumer Protection
Coordinator at AgeOptions.
Dear SMP readers,
This project was supported in part
by grant numbers 90MP0026 and
90MP0127 from the U.S.
Administration on Aging,
Department of Health and Human
Services, Washington, D.C.
20201. Grantees undertaking
projects under government
sponsorship are encouraged to
express freely their findings and
conclusions. Points of view or
opinions do not, therefore,
necessarily represent official
Administration on Aging policy.
What you will find in this week’s Fraud Alert
 Open Enrollment Begins October 15 – Avoid Marketing Fraud
 New! SMP Toolkit Available in Spanish and Korean
 Two Chicagoans Charged in Nationwide Medicare Fraud
Takedown
 Nine Defendants Charged in Home Health Kickback Scheme
 Dentist in Southern Illinois Found Guilty of Medicaid Fraud
Fraud In The News
The following are current
news articles about health
care and fraud issues.
Consumer Fraud:
1. “Debt Collection
Harassment” (AARP):
http://www.aarp.org/mone
y/scams-fraud/info-072012/debt-collectionharassment.html
This week’s Fraud Alert contains warnings about insurance marketing
in the Medicare Open Enrollment Period, two newly translated SMP
materials, and news of two Chicago area defendants charged as part
of the recent nationwide fraud takedown, nine defendants charged in
an alleged kickback scheme, and a dentist found guilty of Medicaid
fraud.
Have a great weekend!
Open Enrollment Begins October 15 – Avoid Marketing Fraud
The Annual Medicare Open Enrollment Period (October 15 – December
7) is the time of year when Medicare beneficiaries can enroll in or switch
Part D or Medicare Advantage plans. During this time, insurance agents
may market their plans to beneficiaries, but they must abide by
Medicare’s marketing rules. For example, agents cannot mislead people
about the plan they are selling (e.g., telling a beneficiary that a plan is
“free” or her doctors are in the plan’s network when they are not).
We encourage beneficiaries to learn more about these rules. Please
view and share the Illinois SMP Tip Sheet on Insurance Marketing:
http://www.ageoptions.org/whatwedo/documents/SMPinsuranceplanmar
ketingtipsheet-color.pdf
The SMP Program has developed a handy questionnaire for clients to
use if they are meeting with an insurance agent. That questionnaire is on
pages 8-9 of our SMP Toolkit, available on our website here:
http://www.ageoptions.org/whatwedo/documents/ToolkitrevisedAug2011-FINAL.pdf (also available in Spanish and Korean)
New! SMP Toolkit Available in Spanish and Korean
The Illinois SMP Program has just released two translated versions of
the SMP Toolkit on its website www.illinoissmp.org.
For the Spanish Toolkit, visit:
http://www.ageoptions.org/whatwedo/documents/SpanishTranslationofTo
olkit_Final.pdf
For the Korean Toolkit, visit:
http://www.ageoptions.org/whatwedo/documents/KoreanTranslationofTo
olkit_FINAL.pdf
Two Chicagoans Charged in Nationwide Medicare Fraud Takedown
This week, Medicare Fraud Strike Force operations in seven cities
brought charges against 91 defendants as part of a nationwide
takedown. Collectively, the amount of allegedly fraudulent claims
submitted by these 91 individuals totals $429.2 million. In the Chicago
area, a dermatologist and a psychologist were charged in two separate
alleged schemes. Read more about the charges brought against these
two individuals in this Department of Justice (DOJ) press release:
http://www.justice.gov/usao/iln/pr/chicago/2012/pr1004_01.pdf
For more about the nationwide takedown, read this DOJ release:
http://www.justice.gov/opa/pr/2012/October/12-ag-1205.html
Nine Defendants Charged in Home Health Kickback Scheme
This week, federal officials announced the indictment of nine Chicago
area individuals, including two owners of a home health agency, for their
alleged participation in a kickback scheme. The two owners and one
employee of the home health company are charged with allegedly paying
the other six co-defendants for referral of patients. The amount of money
paid for each referral ranged from $300 to $600. The company was then
able to bill Medicare for the services provided to these referred patients.
For more information on this case and the details of how this alleged
kickback scheme worked, read this DOJ press release:
http://www.justice.gov/usao/iln/pr/chicago/2012/pr0925_01.pdf
Dentist in Southern Illinois Found Guilty of Medicaid Fraud
A dentist in Mount Vernon, Illinois recently pled guilty to Medicaid fraud
and to illegal distribution of controlled substance Hydrocodone. For more
information, read this FBI press release:
http://www.fbi.gov/springfield/press-releases/2012/jefferson-countydentist-guilty-of-health-care-fraud-and-illegal-distribution-of-controlledsubstances
Jason B. Echols, MSW, Health Care Consumer Protection Coordinator
AgeOptions
1048 Lake Street, Suite 300
Oak Park, IL 60301
phone (708)383-0258 fax (708)524-0870
[email protected]
ageoptions.org
AgeOptions, the Area Agency on Aging of Suburban Cook County, is
committed to improving the quality of life and maintaining the dignity of
older adults and those who care about them – through leadership and
support, community partnerships, comprehensive services, accurate
information and powerful advocacy.
Fraud Alerts contain information about current scams taking place in Illinois, announcements and updates
about programs or services related to health care and/or fraud protection, and links to news articles about
health care and fraud topics. Please forward any recommendations or announcements that you would like to
be included in a future Fraud Alert to [email protected].