Medicare scams are targeting senior citizen in Louisiana

2009/11/19

Health care officials are asking citizens in Avoyelles, East Baton Rouge, Caddo, St. Martin and Terrebonne parishes to be on the lookout for health care scams that are targeting senior citizens.

In each case, the alleged fraud has been brought to the attention of the Senior Medicare Patrol, a new program that is a partnership between Louisiana Health Care Review (LHCR), the Senior Health Insurance Program in the Department of Insurance and the Governor's Office of Elderly Affairs. Kicked off this summer, the Senior Medicare Patrol program is the result of a grant from the U.S. Administration on Aging designed to detect fraud in Medicare.

According to LHCR's Julie Mickles, the Senior Medicare Patrol coordinator, the program teaches senior citizens how to detect and report possible scams that defraud government-run health care programs.

"Each case of potential fraud that we are now investigating has been brought to our attention by seniors who rely on Medicare, and who noticed something wrong or suspicious," she said.

Listed below are some of the complaints that are now under investigation.

Terrebonne Parish: Residents of a senior housing unit are receiving "medically unnecessary" dietary supplements that were prescribed for them by a doctor they have never seen. They are having difficulties getting the shipments to stop. Medicare is paying $820 a month and the seniors are not using the supplements.

St. Martin Parish: A home health agency has billed Medicare for several services that were not received by the homebound senior. A caregiver noticed the discrepancies on the senior's Medicare Summary Notice.

East Baton Rouge Parish: A questionable supplier of medical equipment is trying to get into various housing units to offer arthritis and diabetes supplies that will then be billed to Medicare. The company representatives do not tell the patients the name of the company.

Caddo Parish: A physician reports that several of his patients have been harassed by a medical equipment company that continually calls the patients to offer them "free" arthritis equipment they do not need. The "free" equipment is paid for by Medicare.

Avoyelles Parish: A Medicare patient has reported double billing by his doctor and a hospital. The complaint is under review.

When she receives a complaint, Mickles works with various regulatory agencies to determine if any fraud, errors or abuse is present. When appropriate, she reports to the Medicare Program Safety Contractors, the Louisiana Office of the Inspector General's Medicare Fraud Unit or the Louisiana Attorney General's Medicaid Fraud Control Unit.

"In only a few months of work, the Senior Medicare Patrol has reached out and educated hundreds of senior citizens on how to detect possible fraudulent billings, scams and other abuses. The result is we now have a statewide network of people who are acting as the eyes and ears of the Medicare program. With this network, we've developed strong leads to follow, and been given access to the evidence needed that can lead to the arrest and conviction of suspected fraudsters," said Mike Fields, Special Agent in Charge of the Dallas Regional Office of the U.S. Department of Health and Human Services' Office of Inspector General.