Medicare Compliance & Reimbursement

On June 18, Jane Glenn Haas of the Orange County Register wrote in her post on www.seattletimes.nwsource.com that the Centers for Medicare and Medicaid Services (CMS) had started mailing out "doughnut hole" checks to around 80,000 people across the nation.

Over the course of the next year, Jane goes on to say in her post, CMS estimates 4 million seniors, about 10 percent of those covered by Medicare, will receive these rebate checks which are one-time rebates for eligible seniors who have entered the Medicare Part D doughnut hole.

These $250 Medicare rebate checks are part of the recently enacted healthcare reform package, and are intended to help close the coverage gap (or "doughnut hole") in Medicare's prescription drug program.

What needs to be kept in mind here, it reads in a blog post on www.blogpost.com , is that the checks are mailed automatically -- recipients do not need to provide any personal information at all to receive them.

But it is obvious that not many seniors are aware of this, says Haas, and that is why CMS is spending $1 million on radio, TV and print campaigns to warn them to protect themselves from potential scams and fraud.

According to David Sayen, Medicare Administrator for California, this is just the time to talk about Medicare fraud and about Part D overall.

"We know whenever change occurs in Medicare benefits, there are people out there who try to take advantage of seniors in some way. They may say, 'I'll file for your benefits,' for example, or come up with some other scam to get part of your rebate."

"The important thing for Medicare recipients in the Part D doughnut hole to know is that this rebate is automatic."

But it looks like fraudsters have already sprung into action. In a post on www.suntimes.com, staff reporters Monifa Thomas and Francine Knowles say that authorities have started warning seniors against letting their personal information out to scammers.

Thomas and Knowles said in their post that federal officials are already hearing reports that scam artists have started calling seniors and other Medicare beneficiaries, telling them they need to provide personal information to get the checks. The personal information that these scammers are acquiring include Medicare, Social Security or bank account numbers.

The www.blogcatalog.com post advises that if someone posing as a Medicare representative attempts to solicit personal information, it should be reported by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Also, once a Medicare scam has occurred, it should be reported by calling the Illinois Attorney General's Senior Consumer Fraud Hotline at 1-800-243-5377 or 1-800-964-3013 (TTY) to file a consumer fraud complaint. (Editor's note: Haas's post can be read at: www.seattletimes.nwsource.com/html/health/2012154876_medicarefraudalert19.html. The post at: www.blogcatalog.com is online at: www.blogcatalog.com/search/frame?term=medicare&id=7d8a2b6891ad567a483fee9fc4daf410. And Francine's with Knowles post can be read at: www.suntimes.com/health/2376936,CSTNWS-medicare10. article.)