Medicare Scam Part 2
I continue to be amazed at the resourcefulness of Medicare scammers. This particular one almost escaped my detection.
To recount an earlier post: https://authenticmedicine.com/2021/03/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 called us.
Fraudulent paperwork was soon faxed to our office, requesting more information and signatures. We have seen this before. The faxes will continue until someone inadvertently responds with a signature. Given the volume of paperwork that flows through our geriatric practice every day, this is easy to happen. More faxes will arrive, trying to authorize a variety of expensive pain creams, inferior diabetic supplies, knee braces, etc. 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. So, here is the update:
After a pause of about a week, we started receiving more faxes (shown here, personal info eliminated). The Johns Hopkins heading almost fooled us. Our practice is about two hours from Johns Hopkins and a lot of our patients receive care from their complex of hospitals. It appeared legit… initially. I almost signed it.I paused. The patient was not going to Hopkins as far as I knew. Sometimes, though, patients self refer. I also knew this patient was the same person that had been targeted in the scam described previously.
Then, I looked at the Fax number. It was IDENTICAL to the number in the previous scam and had a Florida Area Code. Hopkins is in Baltimore. Dang! These people are good!
So, what do I do? Report it to Hopkins? What will they do? Report it to Medicare? Medicare could care less…. The reality is these crooks are likely not even in the country. A few days later, another fax appeared, asking me to authorize a prescription for Acetaminophen 30 mg, which is an odd dose, for this same patient. The fax number? It’s the same as in the previous two faxes. I do not quite understand how this particular scheme works. These people are obviously trying to get my signature. Will it then be reproduced onto other documents? So far, the only thing they have tried to get me to authorize is a Tylenol dose I did not even know existed. Does anyone have any ideas on this one?
I often liken our situation in a Primary Care office to being on the front lines. Every hour brings phone calls, faxes, and mailings which are attempts to ensnare us in a new fraud. Our health system is so complex and fragmented, it is easy to hide both semi-legitimate attempts to maximize profits or simple outright fraud. All of these involve getting a doctor or PA/NP to sign something. What scams have I signed off on which totally escaped my radar?
Medicare is going after the major fraud. You know. A family doc billing a 99214.
Large bureaucracies invite fraud. Medicare should never have been instituted, and will never be reformed.
They probably mean Tylenol #3 which is Tylenol with codeine. There is 30 mg of codeine in one tablet of Tylenol #3.
My SOP for these situations is to call the patient at the first request (is it legit/do I need to see pt). When established it’s a scam, write in Sharpie ‘Patient refused. Future faxes will be reported as Medicare fraud.’ and fax back. Usually get a few more attempts, and report them.
You cab be sure there is an acetaminophen 30mg available somewhere–and the cost will be astronomical, with Medicare being billed.