Kathy Fear of Roseville knew something was amiss when her elderly mother-in-law Evelyn Rocconi, who lives with her, started getting packages stuffed with knee and back braces in the mail.
Rocconi, 86, has memory issues, but doesn’t need back and knee braces. She also has no credit or debit card, so couldn’t have purchased the items herself. Yet the packages kept arriving, at one point more than three in the same week. Each time, Fear returned the items to the sending address.
As it turned out, Rocconi had been a victim of Medicare fraud. When her Medicare statement arrived a few weeks later, it listed thousands of dollars in fraudulent charges to the program under Rocconi’s name. Fear suspects a scammer called her mother-in-law on her cell phone and tricked her into giving over her Medicare number. Fear reported the abuse to Medicare.
“It bothers me,” said Fear. “I thought, what if (Rocconi) hadn’t been living with us? How many other older people that are living on their own get ripped off like this?”
Medicare fraud is a rampant problem in California and across the country, sucking billions of dollars in taxpayer money each year from the federally funded health insurance program for seniors. Common scams include billing Medicare for medical equipment or medical services that the senior doesn’t need or didn’t receive, and coercing beneficiaries to enroll in Medicare plans or programs that aren’t right for them but are profitable for the unscrupulous provider or insurance agent.
Ordering back and knee braces that a senior doesn’t need, as happened to Rocconi, is a classic type of Medicare fraud. Fraudsters also persuade healthy seniors to enroll in hospice care. Once enrolled, these seniors find they can’t get treatment for curable health conditions because they’re restricted to only receiving end-of-life care. Other scams involve getting seniors to sign up for unneeded services by offering them free gifts. The abuse can happen in-person, online, through phone calls, flyers, and misleading presentations or television advertisements.
Now, advocates who work with seniors are bracing for a new wave of scams related to the COVID-19 pandemic. Already, California Senior Medicare Patrol, a federally funded organization that helps Medicare beneficiaries avoid, detect and report health care fraud, has received reports of several new scams. Fraudsters have visited residents in senior housing and assisted living facilities offering them “opportunities” for COVID-19 testing in exchange for their Medicare number. Con artists posing as Medicare officials have called seniors and promised them virus test kits or a (non-existent) COVID-19 vaccine if they can verify their Medicare or Social Security number. Some even ask seniors to send them money, said Micki Nozaki, director of Senior Medicare Patrol.
“They’re playing on fear and confusion,” Nozaki said. “Scammers take advantage of whatever is out there.”
In addition to potentially billing for COVID-19-related services, once a scammer has someone’s Medicare number they may use it to file other fraudulent claims, such as for durable medical equipment and doctor’s visits.
California Senior Medicare Patrol operates a hotline that receives around 500 calls a year about Medicare fraud and abuse. The number of COVID-related fraud reports so far is small, but expected to increase. California Senior Medicare Patrol received 8 reports in April, Nozaki said. Advocates help seniors, their caregivers and family members report suspected fraud to state and federal agencies for investigation.
While Medicare fraud has been a problem for decades, COVID-19 has made seniors more vulnerable than ever, said Tatiana Fassieux, a training specialist for California Health Advocates, which operates Senior Medicare Patrol. Many seniors are stuck at home and distanced from family and friends because of the virus.
“When (they) see these too-good-to-be-true advertisements on television or get a phone call, it sucks the person right in because during these times people’s anxiety is much higher, and if they’re alone they want to talk,” she said. “It’s the contact that people are yearning for.”
While fraudsters target seniors from all socioeconomic backgrounds, they prey especially on low-income seniors with limited English proficiency, said Fassieux. The scammers assume these seniors are less likely to ask the right questions or understand how the Medicare program works, she said. They also often need relief and will accept the help the scammers offer, she said.
Additionally, some of the usual channels for warning seniors about Medicare fraud aren’t available because of COVID-19. Many senior centers, nutrition sites, and community events where advocates typically connect with Medicare beneficiaries and provide information about Medicare fraud have shut down because of the virus.
Lupe Garcia, who manages a Medicare counseling program for Kern County’s Aging and Adult Services division, said her office is still counseling seniors over the phone, and recently included informational flyers about Medicare fraud with a distribution of toiletries. But it’s not the same as getting the word out in person, she said. Even as senior centers and other places frequented by elderly community members open up, she worries many seniors will continue to shelter at home.
“It’s a hurdle we’ll have to cross,” she said.
In the meantime, Fear is on the alert for more scams targeting her mother-in-law. She’s learned to listen for signs in Rocconi’s tone of voice that indicate she’s speaking to someone she doesn’t know on the phone. Fear and her husband have warned Rocconi repeatedly not to give anyone her Medicare number.
“It irritates me,” Fear said of the scammers. “It’s going to hurt other people in the long run.”
The California Health Report receives funding from California Medicare Patrol but remains editorially independent.