Seniors Targeted by Scams that could Cost Medicare Billions

Seniors Targeted by Scams that could Cost Medicare Billions

According to an article in Newsweek, seniors relying on Medicare for their health care are being targeted by a widespread "phantom billing" scam that has the potential to rob them of thousands of dollars.

Phantom billing occurs when fraudulent charges are filed to Medicare by health care providers/doctors and medical equipment companies without the recipient's knowledge. Some seniors targeted reported being billed for urinary catheters they never asked for.

While fraud can be orchestrated by health care providers, doctors, and medical equipment companies, all can have substantial impact on the Medicare system and beneficiaries' financial situations.

This fraud contributes to millions of dollars lost, and premiums could end up skyrocketing as a result. In Indiana, the Senior Medicare Patrol said it has received a substantial number of complaints about billing fraud in recent months, but it's likely these scam charges are taking place all over the country.

The National Association of Accountable Care Organizations and the Institute for Accountable Care saw Medicare payments for catheters, for instance, soar from $153 million in 2021 to $2.1 billion in 2023, reflecting the potential widespread phantom billing.

While only 40,000 patients in 2021 saw charges for catheters on their Medicare payments in 2021, just two years later, that number had soared to more than 450,000.

The Federal Trade Commission said fraud and errors end up costing Medicare roughly $60 billion each year that is then passed on to taxpayers.

Senator Mike Braun (R- Ind.) previously requested an audit by the General Accounting Office and also introduced the Medicare Transaction Fraud Prevention Act, which would improve the government's watch of medical equipment purchases under Medicare.

Experts advise beneficiaries to check their monthly statements and report any unauthorized charges immediately. To report suspicious charges, call 1-800-MEDICARE (1-800-633-4227) and speak to an agent.

TSCL has been reporting on the coming insolvency of Medicare if something is not done by Congress soon, but we can all do our part to help the looming Medicare funding crisis by examining the Explanation of Benefits (EoB) we receive from Medicare and make sure there are no charges on there that shouldn’t be there.

As one security expert said, "Just as you periodically monitor your credit card statements and credit reports for unauthorized charges, you should be monitoring your Medicare usage," Jarvis told Newsweek.

"Medicare recipients can log in to the online Medicare portal to review claims or review explanation of benefits reports sent by Medicare. Any charges submitted by unfamiliar medical providers or for unrecognized services should be investigated by the insured."