ALBANY, N.Y., July 17, 2024 /PRNewswire/ — The New York StateWide Senior Action Council (StateWide), an organization dedicated to advocacy for the rights of seniors in New York State, today announced its Medicare Fraud of the Month for July: Telehealth Fraud.

The StateWide Fraud of the Month is a component of the Senior Medicare Patrol (SMP), the definitive resource for New York State’s senior citizens and caregivers to detect, prevent, and report healthcare fraud, errors, and abuse. StateWide is New York’s grantee/administrator for this Federal Program.

“Telehealth lets you consult with your health care provider without an in-person office visit. Patients can receive a wide range of care including check-ins with their primary care providers, mental health care, and specialty consultations. These services can be provided through video chats, remote patient monitoring devices, and phone calls. While telehealth expansion has enhanced access to care, it’s important to ensure that new technologies are not compromised by fraud, abuse, or misuse,” explained Maria Alvarez, Executive Director of StateWide.

She added, “This is how Telehealth Fraud schemes typically work:”

Step 1

Telemarketers contact beneficiaries and request health care information such as their Medicare number or asking to verify their pain symptoms or family history of cancer.

Step 2

The fraudsters pay medical providers to sign orders or prescriptions for unnecessary items without proper patient interaction.

Step 3

The Durable Medical Equipment company, lab or pharmacy then submits false claims to Medicare and Medicaid using the obtained patient information.

StateWide offers the following advice to seniors to protect themselves from Telehealth Fraud:

• Be Sure to Call YOUR Provider: To schedule your telehealth appointment.
• Guard your Medicare Card: Do not give out your personal information to anyone other than your doctor or health care provider.
• Be Cautious of Free Offers: If you receive a phone call from someone offering you free testing, treatment or supplies, hang up, it is a scam!
• Look Out for Suspicious Charges: Review your Medicare Summary Notice (MSN) and Explanation of Benefits (EOB) for improper billing & items that appear that you didn’t order or receive.
• Keep Track of Your Medical Appointments: Write down your telehealth appointments in your Healthcare Tracker and compare them to your MSN and/or EOB.
• If You Suspect Telehealth Fraud: Call the NYS Senior Medicare Patrol at 800-333-4374 or visit www.nysenior.org. Counselors are ready and willing to help!

The NYS SMP and its trained counselors and volunteers help educate Medicare beneficiaries in the fight against health care fraud. It also provides information and educational presentations.

It is estimated that Medicare fraud costs taxpayers over $60 billion dollars nationally per year. To help combat this illicit industry StateWide announced its Fraud of the Month program in 2022 to highlight these scams being perpetrated on the State’s seniors.

SOURCE New York StateWide Senior Action Council, Inc.