Medicare Watch

Health Reform Seeks To Protect Medicare Consumers from Fraud

In order to assure Medicare consumers’ access to new benefits, the Department of Health and Human Services (HHS) is implementing several key fraud prevention measures included in the new health care reform law. In a June 2 webcast, Secretary Sebelius detailed a number of actions HHS and the Department of Justice (DOJ) have taken to prevent Medicare fraud. HHS and DOJ will continue to collaborate on existing fraud prevention programs, such as the Senior Medicare Patrol program (SMP) and the South Florida fraud hotline, which engages consumers in fraud detection and reporting. New efforts to prevent fraud that are part of the health care reform law include steeper penalties for those who violate Medicare rules and improved oversight. For example, HHS hopes to be able to perform comprehensive data analyses to predict and protect against Medicare fraud.

Webcast panelists stressed a number of precautions that consumers and caregivers can take in order to help protect against fraudulent Medicare practices:

• Be aware: Anyone can be a victim of Medicare fraud
• Consumers should guard their identity closely: Call 1-800-MEDICARE to report suspicious behavior
• Do not give out personal information over the phone or internet: If you do not recognize the organization or person asking for your information, do not give information to them. Always ask questions about who they are and why they need your information.
• Know that guaranteed Medicare benefits are the same and consumers do not have to do anything in order to continue receiving them.

Watch the webinar on preventing fraud, waste and abuse in Medicare.

Read about new efforts to fight Medicare fraud in health reform.

Consumers Get More Information on Coverage Gap Rebate

For Medicare consumers who this year have fallen into the coverage gap in Medicare Part D, help is on the way. In mid-June, $250 rebate checks will begin to be mailed to consumers who have reached the gap, which is commonly known as the “doughnut hole.” Consumers who reach the doughnut hole will automatically receive a one-time $250 check. People with Medicare who have Extra Help, the federal program that helps pay for prescription drugs, will not receive a rebate check.

Last week, the Centers for Medicare & Medicaid Services (CMS) released a brochure that provides more details about the rebate. According to the brochure, subsequent mailings of the rebate checks will occur monthly throughout the year. There is no need to apply or fill out any forms, and consumers should not provide personal information to anyone who contacts them about the check. To report fraud related to the rebate, call 1-800-MEDICARE (1-800-633-4227).

Read the brochure.

Dear Marci,

I am having trouble paying for my prescription drugs. My state does not have a Pharmaceutical Assistance Program, and my drugs are not covered by a Patient Assistance Program. Are there any other programs that can help me?

— Alexandra (Aberdeen, SD)

Dear Alexandra,

There may be some charity programs that might help you pay for your prescription costs. You might also want to consider prescription drug discount programs and pharmacies in federally qualified health centers (FQHCs) or hospital clinics. Visit www.medicareinteractive.org to learn more.

The excerpt above is adapted from Dear Marci, our weekly newsletter for consumers. Sign up for Dear Marci.

 

Spotlight

Last week, the House of Representatives passed legislation that prevents a 21 percent cut to Medicare providers, ensuring continued access to doctors for people with Medicare. The Senate must still take action next week to prevent the cuts from becoming a reality. Contact your senators and ask them to stop the payment cuts.