The StateWide Fraud of the Month forms part of the Senior Medicare Patrol (SMP), the leading resource for New York State's older adults and caregivers to identify, avoid, and report healthcare fraud, mistakes, and abuse. StateWide serves as New York's grantee and administrator for this federal initiative.

Maria Alvarez, Executive Director of StateWide, notes, "Hospice provides care and support for individuals facing terminal illness. Emphasis rests on comfort and quality of life instead of curing the condition. Services may cover physician visits, short-term respite care, medications, and equipment for pain relief."

She continued, "Fraudsters approach residents in facilities or visitors at health events to enroll them in unneeded services. Hospice decisions should occur solely between you and your reliable physician."

How the Scam Operates:

Fraudsters approach older adults with promises of:

Free cooking or cleaning help.
In-home assistance or supplies.
False home health checkups.

Yet these offers mask enrollment of seniors into hospice without consent while billing Medicare for unneeded or undelivered care.

How Seniors Can Guard Against These Scams:

Only a physician may approve a patient for hospice care (with a life expectancy of six months or less).
Medicare does not pay for complimentary services like housekeeping.
Never take gifts tied to any services.
Always examine the Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) for unexpected or unapproved charges.

"If seniors receive contact from a scammer or suspect Medicare fraud, they should alert the NYS Senior Medicare Patrol (SMP). Call our Helpline! Contact the New York State Senior Medicare Patrol (SMP) at 800-333-4374. Trained counselors stand ready to assist Medicare beneficiaries against Medicare fraud," Alvarez stated.

StateWide also offers information, educational sessions, help with Medicare questions, plan reviews, appeals, billing concerns, and patient rights for seniors across New York State.

Medicare fraud is estimated to cost taxpayers more than $60 billion each year nationwide. To address this problem StateWide launched its Fraud of the Month program in 2022 to spotlight these schemes targeting the State's seniors.

SOURCE New York StateWide Senior Action Council, Inc.