Feds crack down on medical ID theft and Medicare fraud

By Diana Manos
03:28 PM

Health and Human Services Secretary Kathleen Sebelius and Assistant Attorney General Tony West are urging seniors to take steps to avoid medical identification theft and Medicare fraud.

As part of the Obama administration's ongoing effort to fight Medicare fraud, Sebelius and West unveiled at a Thursday press conference new information designed to help seniors and Medicare beneficiaries "deter, detect and defend" against medical identity theft.

According to HHS officials, medical identity theft occurs when someone steals personal information, such as a name and Medicare number, and uses it to obtain medical care, buy drugs or supplies or bill Medicare. The new tips and a printable brochure were produced by the HHS' Office of the Inspector General and are available online.

"When criminals steal from Medicare, they are stealing from all of us," Sebelius said. "That's why fighting Medicare fraud is one of the Obama administration's top priorities."

According to West, the Department of Justice will continue to collaborate with the HHS "to protect the integrity of the nation's public health programs and vigorously pursue those who seek to take advantage of our most vulnerable citizens."

"Medical identity theft can disrupt your life, damage your credit rating and threaten your health if inaccurate information ends up in your medical records," said HHS Inspector General Daniel Levinson. "OIG's special agents frequently uncover fraud schemes that involve the sale and use of stolen Medicare identification numbers. We're cracking down on these schemes and working to help stop medical identity theft before it happens."

The material released Thursday includes advice for Medicare beneficiaries, such as a reminder to beware of offers of free medical equipment, services or

goods in exchange for Medicare numbers. Beneficiaries are also encouraged to regularly review their Medicare summary notices, explanation of benefits (EOB) statements and medical bills for suspicious charges and to report suspected problems.

Sebelius also highlighted the Senior Medicare Patrol, a program of 5,000 senior volunteers recruited annually to help detect fraud.

"We all have to pitch in and do what we can to prevent our Medicare dollars from being wasted on fraud," said SMP volunteer Joanna T. Gibson of Felton, Del. "And we can start by learning more about what Medicare covers, reading our Medicare statements and reporting provider charges that just don't seem right."

Last May, Attorney General Eric Holder and Sebelius created an interagency effort, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), to combat Medicare fraud. The HEAT team includes senior officials from the DOJ and HHS, and its efforts include the expansion of joint DOJ-HHS Medicare Fraud Strike Force teams that have been fighting fraud in South Florida, Los Angeles, Detroit and Houston. 

According to HHS officials, the HEAT teams have a proven record of success using data analysis techniques and community policing to identify, investigate and prosecute on-going fraud.


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