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'It looks very valid': Valley seniors targeted by COVID test Medicare scam

A nationwide fraud scheme is now showing up on Medicare statements in the Valley.

PHOENIX — A pandemic-era Medicare scam targeting seniors across the country is now hitting Arizona - and we all could pay the price for it.

Medicare statements for seniors across the Valley show clinics that they've never heard of are being paid for home COVID-19 tests that they never received.  

"We alone had four $96 payments by Medicare that were fraud," Jackie Davis of Scottsdale told 12News. "It looks very valid." 

John Appleby of Scottsdale provided his statements showing Medicare was billed almost $800 for five COVID tests by clinics around the country. Medicare paid $94 apiece for three of the tests.

"I told a friend that when she goes to bingo Friday she needs to tell people," Davis said.

Both Davis and Appleby said they called a Medicare hotline that confirmed the fraud was widespread.

By one accounting, COVID fraudsters have ripped off Medicare for about half a billion dollars  

Dana Marie Kennedy, Arizona state director for AARP, says she's been hearing reports about the test fraud in Arizona for a couple of weeks. 

"People are looking at their statement and seeing that Medicare has been billed for COVID testing," she said. "And it's nothing that they know that they've either requested or that they've received."

'We All Pay' for Phony Tests

A couple of important points: 

Medicare's payments for the COVID tests aren't coming out of beneficiaries' pockets. That money comes out of a Medicare trust fund facing challenges to its long-term solvency.

"At the end of the day, we all pay," Kennedy said. "So we want to make sure that we're good stewards of our Medicare benefits."

How Do Fraudsters Get ID Numbers?

But there is a real concern about how the scammers obtained Medicare beneficiaries' identification numbers in order to bill the phony services.

A spokesman for the U.S. Department of Health and Human Services said fraudsters might solicit Medicare enrollees online or on the phone, offering medical services in exchange for their personal information. 

Fraudsters might also purchase stolen Medicare numbers. Data breaches of medical providers' databases are not uncommon.

In April, federal prosecutors in Florida charged a doctor and a marketer with purchasing Medicare beneficiary identification numbers and shipping over-the-counter tests to beneficiaries who didn't request the tests. The damage: more than $8.4 million in fraudulent claims to Medicare.

"If you do believe that somebody has your Medicare number, make sure you report that to Medicare," Kennedy said.

Where to Report Suspected Fraud 

Here are the phone numbers you need:

-Call Medicare to report a Medicare ID number that's being used improperly or a charge you don't recognize: 800-633-4227. 

-Call the U.S. Health and Human Services Department hotline to report a COVID test scam: 1-800-HHS-TIPS (1-800-447-8477). 

-Call the AARP Fraud Watch Network to share the information with millions of members: 877-908-3360.

"We really want to make sure that people are looking at their Medicare statements,  and if something doesn't look right, report it," Kennedy said.

   

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