![]() So far, prosecutors at the Department of Justice have confirmed only one case involving the testing scam. In a statement last month, federal law enforcement officials said "wrongdoers allegedly sought to exploit the program by repeatedly supplying patients or, in some instances, deceased patients, with dozens of COVID-19 tests that they did not want or need." It was the first time the agency agreed to cover non-prescription, over-the-counter products at no cost to beneficiaries. Last year, President Joe Biden's administration offered all households a limited number of at-home tests for free, increasing access to testing as part of its effort to combat COVID.Ī few months later, in April 2022, CMS decided to pay for eight tests per month for those with Medicare Part B outpatient coverage, including tens of millions of seniors, one of the groups most susceptible to severe illness and death from the virus. Sara Lonardo, a spokesperson for the Centers for Medicare & Medicaid Services, confirmed Medicare received complaints about unwanted tests but said they came from only "a small portion" of Medicare beneficiaries who received tests. Some of the more well-known scams have involved medical equipment like power wheelchairs. But the program loses as much as $90 billion a year to fraudulent claims. Medicare spent $900.8 billion providing health coverage to 64 million beneficiaries in 2021. Some private Medicare Advantage plans may continue paying for the at-home tests. When the COVID-19 public health emergency ended on May 11, Medicare stopped paying for over-the-counter tests, though it continues to cover those provided in a clinic, doctor's office, or other health care setting and processed by a laboratory. Complaints around the countryĪlong with those from New York, Indiana, and Ohio, Senior Medicare Patrol directors in Tennessee, Texas, and Utah told KFF Health News they noted a rise in complaints about the unwanted tests as the benefit's cutoff date approached.Īlvarez says lately test suppliers had "gotten more aggressive," calling and emailing seniors - something legitimate Medicare representatives do not do - as well as running misleading internet ads. It is possible that some unwanted packages were a mistake, after pharmacies or other suppliers turned a one-time request into a continuing monthly order, a switch allowed under the program's rules that beneficiaries were responsible for correcting. "Information is the commodity of the 21st century," says Moore, who said she urges beneficiaries to guard their Medicare numbers. In another variation of the problem, Medicare paid for tests for some Ohio beneficiaries who never received them, says Lisa Dalga, project manager for Ohio's Senior Medicare Patrol. None of the people who submitted a complaint recalled giving out their Medicare number, she said. One beneficiary in Indiana suspected something was amiss after receiving 32 unrequested tests over a 10-day period, says Nancy Moore, the Senior Medicare Patrol program director for Indiana. Shots - Health News Hidden audits reveal millions in overcharges by Medicare Advantage plans The organization helps identify and educate beneficiaries about Medicare fraud throughout the country. A stolen Medicare number can be used repeatedly to get payment for all kinds of things or sold to other fraudsters, says María Alvarez, who oversees New York state's Senior Medicare Patrol. Medicare numbers on the dark webīeing targeted once can mean a person is vulnerable to future scams. ![]() ![]() "Unfortunately, most of these schemes are the result of bad actors receiving stolen Medicare beneficiary information," Scott Lampert, assistant inspector general for investigations, tells KFF Health News. Earlier this year, the office posted a fraud warning on its website, urging consumers to report this and other covid-related scams. Department of Health and Human Services' Office of Inspector General has received complaints from around the country about unsolicited tests being billed to Medicare, said a top investigator. It's a signal that someone may have been using, and could continue to use, seniors' Medicare information to improperly bill the federal government. Medicare advocates around the country who track fraud noticed an eleventh-hour rise in complaints from beneficiaries who received tests – sometimes by the dozen – that they never requested. Medicare coverage for at-home COVID-19 tests ended last week, but the scams spawned by the temporary pandemic benefit could have lingering consequences for seniors. It could mean they are at risk for more fraud involving their Medicare numbers. Some older Americans got dozens of COVID tests they never ordered in the mail, just as the free test benefit was ending. ![]()
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