Senior Citizens are routinely targeted for fraud often because they have a “nest egg,” own their home, and/or have excellent credit—all of which make them attractive to con artists. Unfortunately, older Americans are less likely to report a fraud because they don't know who to report it to, are too ashamed at having been scammed, or don’t know they have been scammed. Fraudsters know the effects of age on memory, and they are counting on elderly victims not being able to supply enough detailed information to investigators. Additionally, a victims' realization that they were swindled may take weeks, or even months, after contact with the con artist making it even more difficult to remember details from the event.
Senior Citizens are particularly susceptible to Health Care Fraud or Health Insurance Fraud. These types of fraud can be highly lucrative to fraudsters and devastating to an elderly victim. Some examples include:
Medical Equipment Fraud: Equipment manufacturers offer “free” products to individuals. Insurers are then charged for products that were not needed and/or may not have been delivered.
"Rolling Lab" Schemes: Unnecessary and sometimes fake tests are given to individuals at health clubs, retirement homes, or shopping malls and billed to insurance companies or Medicare.
Services Not Performed: Customers or providers bill insurers for services never rendered by changing bills or submitting fake ones.
Medicare Fraud: Medicare fraud can take the form of any of the health insurance frauds described above. Senior citizens are frequent targets of Medicare schemes, especially by medical equipment manufacturers who offer seniors free medical products in exchange for their Medicare numbers. Because a physician has to sign a form certifying that equipment or testing is needed before Medicare pays for it, con artists fake signatures or bribe corrupt doctors to sign the forms. Once a signature is in place, the manufacturers bill Medicare for merchandise or service that was not needed or was not ordered.
The following tips may prove useful in avoiding Health Care Fraud or Health Insurance Fraud:
ā Never sign blank insurance claim forms.
ā Never give blanket authorization to a medical provider to bill for services rendered.
ā Ask your medical providers what they will charge and what you will be expected to pay out-of-pocket.
ā Carefully review your insurer's explanation of the benefits statement. Call your insurer and provider if you have questions.
ā Do not do business with door-to-door or telephone salespeople who tell you that services of medical equipment are free.
ā Give your insurance/Medicare identification only to those who have provided you with medical services.
ā Keep accurate records of all health care appointments.
ā Know if your physician ordered equipment for you.
These tips are good “rules of thumb” to aid in protecting yourself or those you know against fraud. However, con artists are constantly working to create new scams which prey on elderly victims. If you or someone you know has been a victim of Health Care Fraud or Health Insurance Fraud, please contact us to discuss your legal options.