Another Medical Scam
One of our elderly patients received a phone call from someone claiming to be with her doctor’s office. They began to request personal information. They somehow knew her Medicare number and asked for her social security number. She told them her doctor’s name. Soon, she realized something was very wrong.
She then called our office, asking why we were calling her to ask for information we should already have on file. We assured her the call was not from our office or on our behalf. It was obviously a scam call.
We are very familiar with these. This is what happens next: Paperwork is faxed to our office, requesting more information and signatures. The faxes will continue until someone inadvertently responds with a signature. Given the volume of paperwork that flows through our geriatric practice everyday, this is easy to happen. Then, more faxes will arrive, trying to authorize a variety of expensive pain creams, inferior diabetic supplies, knee braces, etc. The next day, we did, indeed, receive paperwork. It appears above. I blocked out all identifying information. The interesting thing about this particular form is it includes a voice contact number, which is unusual. Typically, these forms have only a return fax number. There is never a physical address, though there may be a Box number. I did call the voice number and it was answered unprofessionally by a guy who refused to give the pharmacy location. This confirmed our suspicion: This was a scam.
The paperwork is coming into our fax machine for this particular patient five or six times a day, every single day. The patient is being called repeatedly and told to urge her doctor to sign the forms. She knows it is a scam now and is frantic.
The harsh reality of geriatric care is a lot of business is transacted via fax with many home health agencies, legitimate pharmacies, oxygen suppliers and others. The volume of faxes our practice receives is about 500 pages per day. That is a simple reality Even with the miracle of electronic health records, this continues to be a fact of life.
This means everyone in our office is vigilant for scams or fraud. If you try to report this fraud to Medicare or anyone, you are met with silence or indifference. We stopped trying long ago.
Anyway, I have reproduced the form here. You can see the “phone number” for the pharmacy is easy to read. Feel free to call it and give them some grief.
I even called the local FBI office to report this fraud. They were not interested. In the past I called the center for Medicare Services about a clear case of fraud by a physician, and again no interest in the matter. Now, when my office mistakenly directly billed a Medicare patient $3.00 for an injection fee, I was called by an investigator and questioned about this. When I checked and informed him of our mistake, he told me “We will let it go this time, but if it happens again, we will prosecute you for Medicare fraud”.
When I was in practice (retired end of 2019) we got things like this all the time. I noticed a pattern that most of them were for folks on an Medicare Advantage plan whose name includes a color and a shape. I reached out to the MA plan about this……and never heard another word.
I think I would hire someone, minimum wage and have them work part time only to deluge this “pharmacy” with return faxes. 100 faxes per day might slow them down. I am serious. I am a big fan of revenge.
I worked for a major insurance company and was supposed to authorize many of these request. Member never had the diagnosis before. The braces were custom. Never had a billed visit from the physician. I wasn’t allowed to call the member. I was told to believe the check boxes and authorize. I had to quit due to ethics (other bjg issues for members not getting what they should). 2019 Feds bust 1 billion dollar fraud in orthotic crime. The company that I worked for paid $83 million fine. No big deal, the members suffer, not the $65 million income from CEO