Archives

COVID-19 and protecting yourself from medicare fraud

Published on: March 19, 2020

COVID-19 and protecting yourself from medicare fraud

Every year, many seniors are targeted by scammers who want to steal their Medicare numbers to do things like rack up fake health care charges and commit identify theft. These scams hurt seniors and other people eligible for Medicare, cost taxpayer’s money and result in higher health care costs for everyone. CMS has set up a webpage with information for Medicare beneficiaries related to COVID-19. You can find it here at www.medicare.gov/medicare-coronavirus.

Medicare covers related needs:

• Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs .

• Medicare covers all medically necessary hospitalizations. This includes if you’re diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine.

• At this time, there’s no vaccine for COVID-19. However, if one becomes available, it will be covered by all Medicare Prescription Drug Plans (Part D).

• If you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Many plans offer additional telehealth benefits beyond the ones described below. Check with your plan about your coverage and costs.

Telehealth and related services:

Medicare covers “virtual check-ins,” so you can connect with your doctor by phone or video or even an online patient portal to see whether you need to come in for a visit. If you’re concerned about illness and are potentially contagious, this offers you an easy way to remain at home and avoid exposure to others.

• You may be able to communicate with your doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit. Medicare pays for “virtual check-ins”—brief, virtual services with your established physician or certain practitioners where the communication isn’t related to a medical visit within the previous 7 days and doesn’t lead to a medical visit within the next 24 hours (or soonest appointment available).

• You need to consent verbally to using virtual check-ins and your doctor must document that consent in your medical record before you use this service. You pay your usual Medicare coinsurance and deductible for these services.

• Medicare also pays for you to communicate with your doctors, using online patient portals without going to the doctor’s office. Like the virtual check-ins, you must initiate these individual communications.

• If you live in a rural area, you may use communication technology to have full visits with your doctors. The law requires that these visits take place at specified sites of service, known as telehealth originating sites, and get services using a real-time audio and video communication system at the site to communicate with a remotely located doctor or certain other types of practitioners. Medicare pays for many medical visits through this telehealth benefit.

Other ways Medicare is helping:

Every day, Medicare is responsible for developing and enforcing the essential health and safety requirements that health care providers must meet. When you go to a healthcare provider, you expect a certain standard of care, and we work to make sure you get it. That includes taking additional steps in response to coronavirus:

• Establishing new codes to allow providers to correctly bill for services related to diagnosis and treatment of the illness,

• Instructing our national network of state survey agencies and accrediting organizations to focus all their efforts on infection prevention and other cases of abuse and neglect in nursing homes and hospitals,

Instructing nursing homes and hospitals to review their infection control procedures, which they’re required to maintain at all times and

• Issuing important guidance answering questions that nursing homes may have with respect to addressing cases of COVID-19.

To protect yourself from Medicare fraud, keep these things to “do” and “don’t do” in mind:

• Do protect your Medicare number and treat your Medicare card like it’s a credit card;

• Do review your Medicare claims for errors and problems, including things like fake charges, double billing or other fraudulent activity, waste or abuse;

• Do visit www.medicare.gov/fraud to learn more about how you can protect yourself from Medicare fraud; and

• Don’t give your Medicare card or Medicare number to anyone except your doctor or people you know should have it.

Reporting Medicare Fraud

If you think you may have spotted fraud, you should report it right away. No matter how minimal the information you share is, it could be the missing piece to stopping the next fraud scheme. If you are a victim of fraud, know that you won’t be penalized or lose your coverage for reporting it. Even if you are not a victim, it’s important to report any fraud scams you encounter to Medicare. Report suspected fraud by calling 1-800-96-ELDER or visit www.floridashine.org and click on the Contact Us tab at the top of the page.

Comments