Pandemic Scammers Target Older Americans on Medicare

Fraud prevention is critical because arrests and prosecutions won't stop the cons emanating from call centers in the U.S. and foreign countries, Day says.

Crooks are like ‘cockroaches'

"That's like trying to exterminate cockroaches by stepping on them one at a time,” she says. “These despicable people can spend their whole day calling and getting hung up on. And that is what we want.”

Fundamentally, keep in mind that Medicare, which provides health insurance for people 65 and older, operates much like a private-sector insurer, as it generally contacts enrollees by mail, Day says.

If you have a problem with your benefits, call 800-MEDICARE. If you haven't initiated a conversation with a Medicare representative, be wary if you get an unsolicited call from someone purporting to be from the program.

If you suspect COVID-19 health care fraud involving Medicare, immediately report it online or call 800-HHS-TIPS (800-447-8477).

When someone calls out of the blue and starts asking for personally identifiable information, invariably it's a ruse, Day warns.

Personally identifiable information (PII) is any data that can be used to identify someone. Examples include your full name, Social Security number, driver's license number, financial account numbers, passport number and email addresses.

Hang up the phone, halt the fraud

"If somebody is calling saying they're from Medicare, the best thing to do is hang up,” Day urges.

The COVID-19 scams aimed at older Americans vary, she says. Some examples:

• Early in the pandemic, con artists were telling Medicare beneficiaries that they were eligible for “COVID Wellness Kits” containing hand sanitizer or face masks. Or they were promised in-home COVID-19 tests or additional Medicare coverage.
• Criminals have been posing as medical or hospital employees, telling people that their doctor wants them to be tested for the coronavirus. The crooks will set up phony appointments and demand that a copay be submitted in advance by credit card, citing a need for contactless payment.
• Fraudsters have been going to people's homes to administer fake tests for COVID-19. They've also set up sham drive-through test sites. Others have touted fake cures and treatments for an illness for which there currently is no cure.
• Con artists have been masquerading as contact tracers.
• Fraudsters are hijacking Facebook accounts and posing as other people, boasting about having received an HHS grant, ranging from $5,000 to $15,000, because of the COVID-19 crisis. On the last point, Day noted that because it may be a real friend of yours whose Facebook account was hacked, the communication may seem legit. But while HHS issues grants to researchers, it doesn't distribute money to people who do nothing in return, she says.

Inevitably, if you pursue such bogus opportunities, you will be asked to pay a fee or a tax in advance — and never see the big bucks.

Day brings FBI chops to HHS

The Office of Inspector General at HHS is the largest of its kind in the government, with about 1,600 employees.

Nenette Day fights Medicare fraud. She is a longtime federal law enforcement official.

HHS OIG

Day, 53, carries a badge and gun and is one of 74 assistant special agents in charge at her agency and oversees its fraud hotline.

She's an Air Force brat born outside Washington, D.C., at Joint Base Andrews in suburban Maryland; her father worked in military intelligence.

With her agency for almost two years, Day earlier worked for 10 years as an FBI agent and spent eight years at the Treasury Department's Office of Inspector General.

Naturally, she's shared her fraud-fighting tips with her mother, who is in her 90s and on Medicare. “Bless her heart; if you call her and she doesn't know you, she hangs up on you. Because I've trained her, and she's never once been the victim of a scam."

Been scammed? Here's where to report it.

• If you believe you've been the target of Medicare fraud, call 800-HHS-TIPS (1-800-447-8477) or immediately report it online.
• If you believe you've been the target of private-sector health care fraud, contact the FBI's Internet Crime Complaint Center.
• If you believe you've been the victim of identity theft, contact the Federal Trade Commission's Complaint Assistant.