Topic of the Month:
Recognizing Medicare Fraud

This week in Marci . . .	Volume 7, Issue 26: Week of June 30, 2008
Dear Marci: How can I help prevent Medicare fraud? Get Resources: Resources to help you recognize and report Medicare fraud. Health Tip: Study shows people avoid doctors when they fear there is no cure. Survey Says: Expanding health insurance is better through public programs.

Dear Marci, I work in a senior center and see how unscrupulous characters can take advantage of people with Medicare who are confused about their health benefits and coverage options. What can I do to help protect my center’s members from being victims of Medicare fraud? —Roger (Denver, CO) Click on the blue, underlined hyperlinks for related information available through Medicare Interactive! Dear Roger, There are several things you can suggest to your members to help them avoid becoming victims of Medicare fraud. First, recommend that they protect their Medicare numbers the same as they would protect a credit card number. Second, point out that if it sounds too good to be true, it probably is. If a provider promises that Medicare will pay for mud treatments, Swedish massages or dance classes (these have all been actual fraud cases), be skeptical. The more your members know about what Medicare covers, the less likely they will be to fall into a Medicare fraud trap. Read the full article on Medicare Interactive to learn more about how to prevent Medicare fraud. —Marci Looking for past Dear Marci Answers? Got other Medicare questions? Find your answers on Medicare Interactive (MI) Counselor, an independent, public resource of the Medicare Rights Center. MI offers expert information and advice on Medicare. Search MI here: Do you need individual counseling? Call the Medicare Rights Center consumer hotline at 800-333-4114, between 9 a.m. and 6 p.m., Eastern Time, Monday through Friday. A Medicare counselor will be happy to answer your question. You can also call your State Health Insurance Assistance Program (SHIP) for personal counseling on Medicare benefits, rights and options. Call Social Security (800-772-1213) for questions about enrolling in Medicare or applying for Extra Help! Feel free to send comments about Dear Marci or suggestions about topics you would like Dear Marci to cover. Health Tip of the Week Are you avoiding a doctor’s appointment or a diagnostic test because you fear that you have a condition for which there is no hope? You are not alone. A study published in 2006 found that many people are reluctant to undergo diagnostic tests if they believe that their condition is both severe and untreatable. In fact, many people went out of their way to avoid finding out any information about their condition at all. However, people were much more likely to pursue diagnostic tests if they believed that there were treatment options available to them. This study speaks to the importance of improving communication between doctors and patients. Part of being an informed patient is considering your options—maybe you want to get a second opinion. Medicare will cover the cost of a second opinion at the same rate as your original visit if your doctor has recommended that you have surgery or a major diagnostic or therapeutic procedure. For more about Medicare coverage and second opinions, read “Getting a Second Opinion Before Surgery” on Medicare.gov. If you are caring for a loved one who is fearful of going to the doctor, you will want to know how to advocate for his or her best interests and make sure your loved one has asked all the questions needed to make an informed decision. Survey Says . . . An analysis published in Health Affairs found that expanding health insurance to people with low incomes through public programs, such as Medicaid and the State Children’s Health Insurance Program (SCHIP), will lower total medical spending more than providing tax subsidies that help people afford private health insurance. Expanding access to such programs would also lower an individual’s out-of-pocket costs, the analysis found. For example, the study found that total spending to provide a year’s worth of Medicaid coverage for an average low-income uninsured adult would have been $3,084 in 2005, compared with $3,899 for private coverage.		Spotlight on Resources Get contact information for the Medicare fraud and abuse hotine. Contact your State Attorney General to report an abusive or fraudulent Medicare plan representative or insurance agent. Get information on Medicare fraud and abuse from The National Consumer Protection Technical Resource Center. * * * * * * MRC’s Hotline for Professionals Do you help people with Medicare? Where do you turn to for help? Call the Professional Hotline, a national service offered by the Medicare Rights Center to support people serving the Medicare population. Dial 877-794-3570 from 10 a.m. to 6 p.m. EDT for accurate, up-to-date information and ongoing technical support. * * * * * * How Can You Get Mental Health Care Covered by Medicare? Check out MRC’s next FREE educational web seminar, "Medicare Mental Health Care Coverage." Please register to attend this online seminar. * * * * * * Newly Updated Medicare Drug Coverage 101 MRC’s Medicare Drug Coverage 101 is an advocate's guide that tells you everything you need to know about Part D. Get a FREE copy of this great resource. * * * * * * Newly Updated Medicare Part D Appeals Help for Advocates MRC’s Medicare Part D Appeals: An advocate's manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples. Get a FREE copy of this great resource. * * * * * * Spread the Word About Dear Marci Tell your friends, colleagues and clients to sign up to receive Dear Marci and other Medicare policy and news updates from the Medicare Rights Center! Subscribe to MRC's other e-newsletters. Dear Marci is a weekly e-newsletter designed to keep you—people with Medicare, social workers, health care providers and other professionals—in the loop about health care benefits, rights and options for older Americans and people with disabilities. Dear Marci is a free service of the Medicare Rights Center.

The Medicare Rights Center (MRC) is the largest independent source of Medicare information and assistance in the United States. Founded in 1989, MRC helps older adults and people with disabilities get high-quality, affordable health care.

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