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How to Avoid Medicare Fraud Medicare fraud costs Medicare an estimated $60-$80 billion per year. We all pay into Medicare with the expectation that our healthcare costs will be covered when we are retired by this government program. When Medicare loses billions of dollars to fraud, we all lose billions of dollars to fraud. Medicare fraud can have a devastating impact on beneficiaries and their families. Most times, people don't recognize fraud has taken place until Medicare denies a payment for a prescrip- tion, service or piece of equipment a beneficiary needs because Medicare has already paid for that service during a fraudu- lent transaction using that person's account. Then, that person or their family has to pay the cost out of pocket. It can be a loss of dignity for the person for being defrauded and can consume many hours of time and emotional frustration repairing the damage done by fraud. It is important to note that neither Medicare nor Social Security Admin- istration (SSA) will call you unless they are returning your call. Initial communication will always be by mail from both agencies. If some- one calls and says they are from SSA or Medi- care, and you have not called them…hang up! You can always call back using the local office for Medicare or SSA. Some other quick clues? ● Medicare won't charge you for a new card. If a caller claims you need to pay a fee to get a new or upgraded Medicare card, it's a scam. ● Medicare doesn't need to "verify" your informa- tion and never threatens to cancel benefits. These are all common scams to steal peoples Medicare information. The scammers have gotten good at disguising their calls. Two different reports from local folks in Santa Cruz County stated scammers had caller ID names listed as PAMF and another as SC Sheriffs. Both calls start- ed with questions related to recent medical office visits followed by re- quests for their Medicare numbers. That clued both potential victims that some- thing wasn't right with the phone calls. Both times the potential victims hung up on the caller, disrupting the fraud scheme. Unfortunate- ly, many more folks do not know the warning signs of a fraud call. Another current scam is for a fraudster to call a victim saying the victim's cardiologist had ordered a cardiac genetic test kit. The fraudster claims they need the victim's cardiologist name and victim's Medi- care number to confirm the victim is the correct pa- tient. A genetic testing kit is sent in the mail with in- structions on how to com- plete the test and send it back through the mail. The fraudster then erroneously bills Medicare upwards of $7500 of which Medicare pays $6000 to the fraudster. Last year in 2021, one in every four cases reported to California Senior Medicare Patrol was a genetic testing scam. Genetic testing fraud occurs when Medicare is billed for a test or screen- ing that was not medically necessary and/or was not ordered by a beneficiary's treating physician. How do you avoid a genetic testing scam? By Bill Proulx ● Refuse to give out your personal information or accept screening services, including a cheek swab, from someone at a com- munity event, local fair, farmer's market, parking lot, mall, senior center, home show, church-spon- sored wellness event, and/ or any other large event. ● Go to your own doctor to assess your condition, not a doctor on the phone you've never met from a company you don't know. ● Always read your Medi- care Summary Notice (MSN) or Explanation of Benefits (EOB). The words "gene analysis" or "molecular pathology" as service codes may indi- cate questionable genetic testing. ● Refuse the delivery of any genetic testing kit that was not ordered by your physician. ● Be suspicious of anyone who offers free genetic testing and then requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes. ● Contact the California Senior Medicare Patrol (SMP) for help. SMPs across the nation empower Mortgage Rates Just Went Over 6%! Last week looked relatively calm compared to the prior week and weekend. Although it seems like the rates went up overnight, they have been on the rise for the past three months as ru- mors of a Federal Reserve rate hike were making headlines. After nearly a decade of very low rates in the 3% range they had crept up to 5% and then over 6% but after the announcement of the ¾% increase in the Fed Funds Rate they went down. Why would a rate hike lead to lower rates? The short answer is that the bond market, which dictates mortgage rates, has almost always already adjusted rates on the ru- mors ahead of time, so by the time the Fed actually takes action, it's old news to the market and there is a sense of relief as the traders can stop worrying about uncertainty and get on with business. The best news was the com- ment that ¾% rate hikes will not be common! If you already have a Reverse Mortgage weather it is a fixed or an adjustable with a credit line, my advice is to stay the course. The adjustable programs have rate caps, usually 5% over the start rate, to protect you from runaway rate increas- es. There is no need to make a change now. Your credit line is safe from any freeze or reduction and your funds are available whenever you request them. The size of your credit line was established when your loan was ap- proved and funded and the growth rate of that credit line was established then too. The security of this program really becomes meaningful in uncertain times. If you remember one of my reoccurring ads which simply said "In uncertain times it's Better to Have and Not Need than to Need and Not Have". Well, these are those times! The housing market still has very low inventory so home values and stored equity, called "Lazy Equi- ty" in the financial world, is still available to you with a Reverse Mortgage. After the repricing and recalculating of loan size by all the lenders in the Reverse Mortgage mar- ketplace there is still room to pay off an existing loan and have funds available either in a lump sum with a fixed rate or in a credit line on the adjustable, in most cases. It's Not Too Late! The protection and capture of your home eq- uity can only be achieved if you take action. If home values go down because of an affordability crisis, your equity evaporates. It may not be the 50% decline that we saw in the Financial Crysis of 08-09 but the market could cool off for a year or two. I don't know. As seniors, we don't have the luxury of time to wait for a recovery if we are not prepared. Donald Dimitruk is a Registered Financial Consultant ® and a Reg- istered Mortgage Advisor and is available for a FREE consultation about how a Reverse Mort- gage may benefit you at 831.464.6464 but then they would be inheriting not only their family home but one with "No monthly payment for life" as well and turn their existing home into a rent- al to subsidize the tax and insurance expense and build a larger Real Estate portfolio for retirement. What a concept! Donald Dimitruk is a Registered Financial Consultant ® and a Reg- istered Mortgage Advisor and is available for a FREE consultation about how a Reverse Mort- gage may benefit you at 831.464.6464 By Donald Dimitruk RFC ® RMA and assist Medicare bene- ficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse. Another fraud scheme is for braces. Watch out for scammers broadcast- ing TV commercials or calling you by phone to offer "free or low cost" knee, back and other orthotic braces. If you give them your Medicare number, you could end up with boxes of unwant- ed and unneeded braces, a compromised Medicare number, and potentially denied Medicare claims if you require such braces in the future. Medicare only pays for durable medical equip- ment based on medical necessity — meaning it's an item you really need for your medical condition – and requires prescription from your doctor, not a doctor you've never met, or a doctor on TV. How do you protect yourself from this type of fraud? ● If you receive a call from someone of- fering you a "free" brace covered by Medicare, hang up immediately. ● If medical equipment is delivered to you, don't accept it unless it was or- dered by your physician. Refuse the delivery or re- turn it to the sender. Keep a record of the sender's name and the date you returned the items. ● Be suspicious of anyone who offers you free med- ical equipment and then requests your Medicare number. If your personal information is compro- mised, it may be used in other fraud schemes. ● Only your doctor should prescribe and/or approve any requests for durable medical equipment. Always be cautious of unsolicited requests for your Medicare number. Do not give your Medi- care information to anyone you don't know. If you, a loved one or a client you know come across such scams, please report them to the California SMP at 1-855- 613-7080 or your Santa Cruz County HICAP at 831-462-5510. See the HICAP website at www.seniornetwork- services.org for upcoming Medicare education and Medicare Fraud presenta- tions. HCO# 444700020 600 Frederick Street • Santa Cruz, CA 95062 • (831) 469-4900 • www.lifespancare.com Home Care Personalized care up to 24 hours a day by experienced and registered home care aides. Enhancing life and finding joy through activities that increase engagement, fulfillment, and a sense of connection. Well-Being Program Care management promotes peace of mind through professional, person-centered assessment, coordination of personal care, medical, and social needs. Care Management AGING CARE YOU CAN TRUST SINCE 1983 In honor of Gay Pride month in June, Lifespan would like to acknowledge our community's Lesbian, Gay, Bisexual, & Transgender older adults. Your everyday demonstration of strength and resilience is inspiring. 1777-A Capitola Road, Santa Cruz 95062 www.seniornetworkservices.org A Nonprofit Community Agency Santa Cruz County's Official Information & Assistance Provider call: 831-462-1433 email: info@seniornetworkservices.org Unbiased, No Cost Medicare Counseling Santa Cruz call: 831-462-5510 San Benito call: 831-637-0630 email: hicap@seniornetworkservices.org Shared Housing I Housing Navigation I Home Help call: 831-462-6788 email: housing@seniornetworkservices.org Respite Registry I Respite Grants call: 831-462-0880 email: respite@seniornetworkservices.org SENIOR NETWORK SERVICES Am I Too Late to Get a Reverse Mortgage?