Legal Update

Mar 23, 2020

Insurers, ERISA Plans and Other Payors:  Beware of COVID-19 Fraud Schemes!

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On March 23, 2020, the U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”) issued an alert to the public about fraud schemes related to the novel coronavirus (COVID-19).

According to the alert, scammers are offering COVID-19 tests to Medicare beneficiaries in exchange for personal details, including Medicare information. However, the services are unapproved and illegitimate. Fraudsters are targeting beneficiaries in a number of ways, including telemarketing calls, social media platforms, and door-to-door visits.

These scammers use the coronavirus pandemic to benefit themselves, and beneficiaries face potential harms. The personal information collected can be used to fraudulently bill Federal health care programs and commit medical identity theft. If Medicare or Medicaid denies the claim for an unapproved test, the beneficiary could be responsible for the cost.

The HHS OIG alert identifies five ways for members of the public to protect themselves: (1) beneficiaries should be cautious of unsolicited requests for their Medicare or Medicaid numbers; (2) be suspicious of any unexpected calls or visitors offering COVID-19 tests or supplies. If your personal information is compromised, it may be used in other fraud schemes; (3) ignore offers or advertisements for COVID-19 testing or treatments on social media sites; (4) a physician or other trusted health care provider should assess your condition and approve any requests for COVID-19 testing; and (5) If you suspect COVID-19 fraud, contact National Center for Disaster Fraud Hotline (866) 720-5721 or disaster@leo.gov.

Here is a direct link to the HHS-OIG public alert: https://oig.hhs.gov/coronavirus/index.asp?utm_source=web&utm_medium=web&utm_#.XnkeKV2IgDo.linkedin

It has been estimated that fraudulent insurance and benefit claims cost the U.S. health care system hundreds of billions of dollars per year. It is disappointing but unfortunately not surprising that fraudsters would attempt to profit off the current health care crisis. What remains to be seen is whether and to what extent they get away with it.  Stay tuned.