Healthcare is a multi-billion dollar industry. Where there is money, there are fraudsters and scammers. The healthcare industry has more than its share. Some of these scammers target Medicare and health insurers but many target individuals. Don’t be one of their victims.
Healthcare fraud against individuals takes many forms. One involves calling a patient, often an older patient who is a Medicare beneficiary, and obtaining confidential information, which can be used to file phony health claims or to enroll the victim in a Medicare Advantage plan without their knowledge.
Scammers are very sophisticated these days. They can manipulate the caller ID feature on your phone to make their calls appear to come from anyone they choose. They can do the same with emails. For this scam, the caller ID on the phone may say that the call is coming from your local hospital or from Medicare itself. The person on the other end offers up a plausible excuse for needing to “confirm” the victim’s Medicare number. Sometimes the excuse is coupled with a threat that, unless the victim provides the information, Medicare will cut off their benefits and they will have to pay for medical care personally. These scammers have given lots of thought to just the right formula to coax the data out of the victim. Don’t give out personal data to anyone who calls you. If there appears to be a real need for data to be given out, hang up and call back to a number you are sure is a legitimate number. Do not use the number give you by the caller.
Another form of healthcare fraud involves people pretending to be doctors or other healthcare providers. They often prey upon people in lower income communities, who don’t have health insurance or who don’t have much experience with doctors. The scammer offers personalized medical care, sometimes at a discount but sometimes for a very substantial amount of money. It is bad enough if the only thing taken by these scammers is money but I have seen a number of cases in which the fake doctor performed some sort of procedure on the victim and caused serious injury or death. Make sure you check the credentials of any healthcare provider before going for treatment.
Real doctors are not immune to the temptation to defraud patients. During the COVID pandemic, some real physicians sold wonder drugs guaranteed to stop COVID in its tracks. Others sold advance COVID treatment packages that would entitle the victim and his or her family to concierge care from the physician, in the event any of them contracted COVID. The old adage has a lot of merit, “If it seems too good to be true, it probably is.”
Real doctors sometimes hold themselves out as qualified and experienced when they are not. As I have mentioned in other posts, once a doctor is licensed, she can do pretty much any procedures she wants, so long as she can do them in her office or a local surgicenter. We see this with some frequency in cosmetic surgery. There is a lot of money to be made in cosmetic surgery and that money attracts doctors who have not been trained as cosmetic surgeons. Maybe they have taken a weekend or week long training offered to give them some skills but that is a far cry from a three year plastic surgery residency or a year-long cosmetic surgery fellowship. A few years ago, a Phoenix doctor, who was not a trained cosmetic surgeon, did liposuction on a woman and ended up killing her. Don’t let that happen to you.
In addition to holding themselves out as qualified to do procedures for which they have not been properly trained, some real doctors defraud their patients by recommending unnecessary surgeries or treatments that will put money in their pockets. There have been cases of doctors lying to patients and telling them they have cancer so the doctor can give them expensive cancer treatments. Remember, just because a doctor says it does not make it true. Get a second opinion before any major surgery or course of treatment, like chemotherapy, that can cause significant bodily harm.
Beware of health care scammers. Be skeptical. Be cautious. Be alert.
