The New York StateWide Senior Action Council (StateWide), a 54-year-old nonprofit organization dedicated to serving the needs and well-being of our state’s more than 3.6 million seniors, has announced its “Medicare Fraud of the Month” alert for this September: outpatient mental health care fraud.
StateWide’s “Fraud of the Month” initiative is part of the Senior Medicare Patrol (SMP) program, the go-to resource for seniors and caregivers in New York State to detect, prevent and report healthcare fraud, errors and abuse. StateWide is the grantee/administrator of this federal program in New York.
María Álvarez, CEO of StateWide, explains: “Medicare covers outpatient mental health care, including some telehealth services. Fraud can occur when Medicare is billed for services that were not received, were not necessary, or were different from the care provided.”
In this sense, StateWide advises older people to be vigilant if:
– No visit occurred: Medicare was billed for a telehealth visit that never occurred.
– Incorrect billed time: Medicare is billed for a longer therapy session than received.
– Repeat visits appear: A Medicare statement shows several telehealth therapy sessions that were never received.
Older people should inform themselves well before trusting someone:
– Find out who provides the services.
– Understand why this service is necessary.
– Keep track of all appointments.
– Never give your Medicare number to someone who calls you by surprise.
– Review the Medicare Summary Sheet (MSN) or Explanation of Benefits (EOB) to identify charges that are unfamiliar to you
Alvarez added, “If you see something on your Medicare statements that doesn’t seem right, such as services you haven’t received, a provider you don’t recognize, or services billed that don’t match the care you received, contact the New York State Senior Medicare Patrol (SMP).”
You can contact the New York State Senior Medicare Patrol (SMP) by calling 800-333-4374 or by visiting www.nysenior.org.
It should be noted that StateWide has qualified advisors to help Medicare beneficiaries in the fight against fraud in this program.
StateWide also provides information and educational talks, as well as assistance with Medicare-related questions, plan comparisons, appeals, billing issues, and patient rights to all seniors in New York State.
Medicare fraud is estimated to cost taxpayers more than $60 billion annually nationwide. To help combat this illicit industry, StateWide announced its “Fraud of the Month” program in 2022, to highlight these scams committed against seniors in New York State.
