Tag Archives: identity theft

Health care fraud: up to 10% of your medical expenses


Health care fraud is hardly new. However, according to a recent report from BDO, an accounting and consulting firm based in the U.K., it is responsible for up to 10% of all health care costs in the U.S.  For Medicare specifically, fraud represents $60 billion, or 10% of annual Medicare expenditures.

$1 billion Medicare fraud case just announced

The Justice Department recently announced the largest health care fraud case ever brought against individuals in this country. Philip Esformes, owner of about 30 nursing facilities in Florida has been charged with defrauding Medicare and Medicaid of more than $1 billion.

Preying on the elderly: At the core of the fraud scheme, prosecutors maintain, was cycling 14,000 older men and women in and out of nursing homes and assisted living facilities–whether they needed medical care or not. Esformes is also accused of giving narcotics to elderly patients. That way, patients had to stay in the facilities even longer, to treat their addiction.

Esformes and two other defendants billed Medicare for medical care, medical equipment, and high-priced drugs that patients either didn’t need or never received. The scheme involved paying kickbacks to doctors, pharmacists, health care consultants and other medical personnel.

The amount of cash taken by Esformes over the last 14 years: more than $4 million. The money paid for a “$600,000 watch, the leasing of private jets and chauffeured limousines, and periodic trips with escorts to a Ritz-Carlton Hotel in Orlando,” as reported in the NY Times.

What you can do to help prevent health care fraud

Prosecutions for health care fraud have increased recently. But $100 billion in estimated annual fraud costs is still a huge number. As is the case with other types of fraud–such as identity theft and e-mail scams–each of us can help protect ourselves and others.

Here, from the Centers for Medicaid & Medicare Services, are the key types of health care fraud,  some key ways in which all of us can help prevent, stop, and report the fraud that costs us so much money, and contributes to steadily rising health care premiums.

  • Take notes: Keep track of the dates and times of your doctors’ appointments, what occurred, and what treatments or medications were prescribed during those appointments.
  • Check statements: If you–or your parents–are covered by Medicare, check every statement that comes in.  See if Medicare was billed for diagnostic tests or services that the doctor never provided; look for anything that seems unusual.
  • Say “No” to freebies: If anyone approaches you anywhere and offers free services, groceries, or anything else in exchange for your Medicare number, say, “No, thanks” and walk away.
  • Never give out your Medicare number on the phone: If anyone phones and asks you to participate in a  “health survey,” then asks you for your Medicare number, hang up.
  • Ask questions: If a doctor, other health care provider, or a supplier tells you that medical equipment or services are free, and that all you need to do is give them your Medicare number, be suspicious. Ask how the cost of the equipment or treatments will be paid. Then ask yourself if the answer seems reasonable.
  • If you suspect Medicare fraud of any type, call 1-800-Medicare.
  • If you suspect any other type of health care fraud, call 1-800-HHS-TIPS.

See more posts on how to protect yourself or your parents, from becoming fraud victims.

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Smartphone scams are particularly dangerous

 Forward-all-spam-to-7726-croppedAs we’ve talked about in this blog,  phishing scams are a growing threat to everyone. Basically, phishing e-mails are attempts at identity theft. Scammers try to get you to click on a link that puts malware on your computer. Or they ask you to validate your personal information, account numbers, passwords, Social Security number, etc.—all in an attempt to steal your identity.

Texts more likely to be fraudulent

Now, according to Sid Kirchheimer, author of Scam-Proof Your Life, fraudsters are turning their attention to smartphones. The reason, he reports, is that people are three times more likely to respond to texted spam on their cell phones than they are to iffy e-mail messages on desktops or laptops.

The danger, Kirschheimer notes, in the March issue of the AARP Bulletin, is that more than one-fourth of the text-message spam you receive is intended to defraud you. This compares with only about 10% of spam that arrives in your e-mail Inbox.

Among the most common smartphone scams:

  • Voice messages telling you have won a sweepstakes prize or that a package was unable to be delivered to you.
  • Calls that ring only once. (The idea is for you to call back out of curiosity and pay $30 or more for an international call when you do.)
  • Callers who hang up when you answer (Also $30+ phone bills when you reply.)
  • Messages supposedly from your bank or credit card company that there is a problem with your account, and asking you to click a link.

Stay safe from smartphone fraud

Don’t answer: The smartest way to avoid cell phone scams is the same as it is with any suspicious e-mails: Don’t answer or reply to them.

If you’re concerned about any possible problems with your bank or a credit card company, call the bank or credit card issuer yourself—using a phone number you know is correct.

If you believe a call is coming from a legitimate business, and you want to be removed from their phone list, hang up and call them yourself. Don’t press any numbers, assuming that will prevent future calls. That may be the way scammers double-check that they have a working cell phone number.

Be wary of unfamiliar phone numbers: Consider not answering any phone calls that come from unfamiliar numbers. If the person leaves a voice message, you’ll have an opportunity to determine whether the call is legitimate, or a likely scam. Then you can follow safety precautions.

Dangerous area codes:  Do not answer or respond to calls from unfamiliar area codes. Specifically, Kirchheimer warns, beware of calls that come from the following area codes: 268, 284, 473, 649, 664, 767, 809, 829, 849, or 876.

Don’t click: The same goes for unfamiliar texts. Don’t click on any links at all.  If you’re offered the opportunity to unsubscribe, don’t do it. That only confirms that the fraudsters have your correct wireless phone number.

Similarly, go to the URL, or Internet address, of any company you believe may have sent a legitimate message. Contact customer support or technical support at the actual company’s Website or phone number.

Forward spam texts to 7726 (SPAM):  All of the major wireless phone providers permit you to forward spam calls to them at no cost. Doing so may not stop spam contacts immediately. But it should help the providers develop better security systems—and hopefully, systems that will prevent such calls from getting through in the first place.

See more posts on how to protect yourself, your family, and your business from various forms of cyberfraud and identity theft.

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Why to tell the IRS if you’ve been a victim of identity theft


You may already be a victim of tax fraud due to identity theft. Or you may have had your identity stolen–but not been hit by tax fraud.

Either way, let the IRS know.  File form 14039

Has someone else already filed a return using your Social Security number? In Section A, check Box 1

You’ll know you’ve been hit by tax fraud if your e-filed return is rejected as a duplicate. Or if you  receive a mailed notice from the IRS stating that a return already has been filed using your Social Security number. Any “duplicate” return will be rejected by the IRS.

You still must file your 1040 and pay any taxes due. But your return must be submitted by paper, not electronically. Attach Form 14039. You’ll also be required to submit one of the following to verify your identity: a copy of your driver’s license, Social Security card, or passport.

You can’t have your own return accepted, or obtain any tax refund due until you submit the form and the required documentation.

Besides filing Form 14039, be sure to file a report with your local police precinct. And also notify the Federal Trade Commission.

Has your identity been stolen, but you don’t know if a fraudulent tax return has been filed? File form 14039, anyway. In Section A, check Box 2

If someone has already used your Social Security number to obtain credit falsely, file the form. If your wallet has been stolen, your house has been burglarized, or you suspect that your Social Security number may have been compromised during a computer hack, protect yourself. File form 14039, even if you don’t know of any crime that has been committed by using your ID.

If the IRS is aware of your identity theft, and a fake tax return is filed using your Social Security, it should be flagged before it is processed–which could save you a lot of aggravation.

Check out some more solid advice on identity theft from the IRS.

We’re noticing that identity theft has begun to show up in local police blotter features. Are you seeing reports in your newspaper?

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