Medicare phone scam

At 73, Marlene Myerson has heard from Medicare a time or two with correspondence from the federal benefits provider typically arriving in the mail.

One day she received a call.

"This is Medicare and we're sending out new Medicare cards," Myerson said the voice on the other end told her.

She said it sounded legitimate.

The new Medicare cards have some sort of chip in it, they told her.

"It's like a different kind of card, so I figured I needed it," she said.

Then the caller asked for something strange. He asked the name of her bank.

"I said, ‘Well why would you need that?' "

""Well, we need it," Myerson said he told her.

So Myerson hung up. But that wasn't the end of it.

"They called one more time," said Myerson.

"We're calling about the Medicare card," she said the caller told her.

The caller insisted the new card was something Myerson must have.

So the Contact 5 Investigators checked with Cecilia Franco, who runs the Miami office for The Program Integrity Group, an arm of Medicare that is charged with cracking down on Medicare fraud.

"There is no microchip, no card, there's nothing happening," she said.

"This is not happening. For all the viewers please don't share any information over the phone," she said.

Franco says this is just the latest round of bogus billing that steals taxpayers' money and your benefits too.

The Contact 5 Investigators uncovered part of the problem five years ago as we tracked businesses from Orlando to Miami looking for the people ripping you off.

We documented the case of Nanette Zoloroffe, who discovered she was a victim of medical equipment fraud when she found bogus bills showing up on her Medicare account.

"I never ordered any of this. I didn't expect any of this and this is almost $20,000 that has been paid out by Medicare."

Nanette is a cancer survivor. She didn't have a wheelchair, didn't need a wheelchair--never got a wheelchair, but taxpayers paid for her wheelchair attachments like arm and leg rests.

"It's wrong. It's totally, totally wrong," she said.

Something similar happened to a group of seniors who attended a forum hosted by NewsChannel 5.

"I've been billed over $11,000 for something I didn't need, didn't use or receive," said one participant.

Besides the fleecing of tax money, we found all these seniors were losing benefits too. Should they get sick and really need the equipment they were wrongly billed for they would be denied because Medicare records show they already got it.

"What happens if I need some of this equipment? I'm sick," said Nanette Zoloroffe. "Well let me show you something. I'm going to show you I have cancer and I'm in chemo and they don't care--but you keep billing me for things I don't have."

Everyone gathered at that meeting agreed to make changes and promised to do better. But fast forward five years and Cecilia Franco says fraud is still a big problem.

"How big is the fraud--dollar amount?" I asked.

"It's a lot. I think it's a lot," she said.

In 2009 the General Accounting Office, in a report titled Medicare Fraud Waste and Abuse, estimated $24 billion was being essentially stolen from taxpayers. In a follow-up report dated March 2010, another bruising report from the GAO that the Centers for Medicare and Medicaid failed to "promptly resolve the vulnerabilities" in the system that were identified in the earlier report.

Cecelia Franco says the Centers for Medicare and Medicaid has a new plan to tackle the fraud, one she hopes will stem the loss quickly.

"What we are trying to do now with this predicting modeling. We're trying to stop the claims when we are suspicious they are not a clean claim and stop it before it gets paid."

But until then, seniors are being heeding the warning.

"This junk that goes on is disgusting, absolutely disgusting," said Myerson.

 

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