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Día Once: ¡Luchemos Contra el Fraude al Medicare en el 2015!

En los próximos 12 días estaremos compartiendo escritos diarios para motivarles a pensar en la salud y el bienestar suyos, de sus padres y abuelos y de toda la familia durante en las fiestas de fin de año. Algunos escritos ofrecerán consejos cortos, mientras que otros llamarán a la reflexión. Esperamos que estas palabras lo inspiren y que las comparta con sus amigos, vecinos y seres queridos. 

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El fraude en el cuidado de salud es uno de los mayores tipo de fraude afectando a los adultos mayores, especialmente nuestros abuelitos. Esto es a causa de múltiples factores como poco dominio del idioma, aislamiento y miedo a las autoridades hacen que los adultos mayores hispanos sean blancos vulnerables, por lo que entender lo qué es el fraude al Medicare y cómo prevenirlo es tan importante para nuestros padres y abuelos.

A través del programa National Hispanic SMP, NHCOA ha desarrollado una una serie de videos educativos cortos para adultos mayores hispanos y sus cuidadores sobre el fraude al Medicare. Esta serie forma parte de un catálogo de recursos disponibles en español para ayudar a adultos mayores, sus familiares y cuidadores a proteger, detectar y reportar el fraude al Medicare.

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Durante esta época navideña, compartamos el regalo de la información y la educación con nuestros queridos padres y abuelos para que puedan unirse a la lucha contra el fraude al Medicare y protegerse de personas malintencionadas.

Si sospecha que un ser querido ha sido víctima del fraude al Medicare, puede llamar al National Hispanic SMP para una consulta gratuita en español al 1-866-488-7379. 

Day Eleven: Join the Fight Against Medicare Fraud in 2015!

Over the next 12 days, we will be sharing daily posts to motivate you to think about your health and well-being during the holiday season. Some posts will focus on handy tips, while others will offer a reflexion. We hope these words will inspire you and we invite you to share them with friends, neighbors and family.   

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Health care fraud is one of the most pervasive types of fraud targeting seniors, especially Hispanic older adults. Multiple barriers such as limited English proficiency, isolation, and fear of authority make Latino seniors vulnerable targets for unscrupulous scammers, which is why understanding what Medicare fraud is and how to prevent it is so important for our parents and grandparents.

Through the National Hispanic SMP program, NHCOA has developed a series of short educational videos for Hispanic older adults and caregivers that cover Medicare fraud basics. These videos are part of a catalog of Spanish language resources available to help Latino seniors, their families, and caregivers protect, detect, and report Medicare fraud.

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During the holiday season, let’s share the gift of awareness and education with our beloved parents and grandparents so they can join the fight against Medicare fraud and protect themselves from scammers and con artists.

If you think your loved one has been a victim of Medicare fraud, they can call the National Hispanic SMP for a free consultation in Spanish at 1-866-488-7379.

Help Latino Seniors Protect Themselves from Medicare Fraud on Grandparents Day

Many of us have fond memories of our grandparents: hanging out with them on holidays, sharing something sweet to eat, hearing stories of days gone by. They’d greet us with warm hugs and big smiles, spoil us rotten, brag about us to their friends, and we thought they were just the most wonderful people in the world.

Well, many of these wonderful older adults can also fall prey to Medicare fraud because they are so trusting and tend to give people the benefit of the doubt. We all know of those older adults that contribute money to what they think is a worthy cause because someone called them up and tugged at their heart strings. We’ve all heard of those older adults who lose their entire retirement savings to some scam that ended being too good to be true. The same thing happens with Medicare.

Medicare fraud is a multi-billion dollar problem in the United States, and there are all kinds of unscrupulous folks out there waiting to pounce on unsuspecting older adults. In fact, the FBI estimates that Medicare fraud could be as much as $60 billion a year, or about 10 percent of all healthcare expenditures in the country, and it’s expected to go up as the number of older adults increases. That’s money that’s not being used for much-needed healthcare services.

In fact, federal officials call Medicare fraud a crime against healthcare. Did you know that the Affordable Care Act authorizes more jail time if the Medicare fraud involves a million dollars or more? The scammers and unscrupulous people who rip off our older adult population can spend from 20 to 50 percent more time behind bars for scams that involve significant amounts of money. The federal government is serious about catching the fraudsters; we all should be.

Latino older adults are especially vulnerable because some have little or no knowledge of English, they are afraid to ask questions, they have low levels of formal education and very low levels of health literacy.  Moreover, many don’t have enough resources to transport and go to places to access information. Others aren’t sure how to navigate a rather daunting bureaucracy and they’re not sure where to turn for help, so when they see someone who they think   might be helpful,  they put their trust in that person.

What can we do about it?  Talk about it.  Spread the word to prevent Medicare fraud.  Sunday, September 7th happens to be National Grandparents Day, and that’s the perfect time to talk to your grandparents or other older adults about Medicare fraud. Besides spending the day with them, taking them out to eat, or just going over for a nice long visit, make sure they know never to lend their Medicare card out to anyone, and to be real careful who they give their personal information to over the phone. Have them look over their Medicare statement to make sure there aren’t any charges that don’t look right. Report any inconsistencies. The National Hispanic SMP, a Medicare fraud prevention program can help you with additional information: 1-866-488-7379.

Everyone benefits when we all come together to fight Medicare fraud. It’s your money. Let’s work together to keep more of it.

 

Medicare Fraud Outreach in the Latino Community is ALL about Partnerships

What makes the Latino community so hard to reach and why is it so hard to fight Medicare fraud in the community?

It’s because this is a unique community. There are cultural and linguist challenges that the community faces. Many people in the community have very low levels of education and low levels of health literacy, and they don’t know how to navigate the system and don’t know what to ask. Sometimes they don’t even know there are programs that they can use and many are very trusting. It’s especially difficult for older Latinos who are also low income, because it’s hard for them to turn down something they get for free, even if they’re not supposed to get it.

But it’s not a lost cause. There are some very effective ways to reach the Latino community and it’s all about thinking in terms of two key words: personalization, and partnerships. Older Latino adults don’t want to be talked down to. They want to feel a personal connection with people and they want to be able to trust that the person they are speaking with is giving them the right information.

That’s why is so important to do to where they are: the places of worship, the community centers, the beauty parlors; anywhere that the community happens to be. Go where they are and talk to them.  And this is where partnerships are important: a partnership with local community leaders and a partnership with members of the media so that they can help you get to the members of the community, and achieve that most important partnership of all: a partnership with older Latinos.

First of all, the Spanish language itself is not monolithic.

Don’t assume that the words that are spoken in the Latino community in Los Angeles, for instance, are the same as the Latino community in Miami or New York. Cultural competency goes beyond language. It’s not enough to be able to speak the language, but rather requires a good understanding of the community. The same word may mean something completely different depending on where members of the community are from. This is where having a relationship with local community leaders becomes very important.

We can’t go into different communities and say the same thing. We have to be mindful of the differences.

Sure, there are many commonalities, such as the importance of family and working together and we definitely have to build on that, but working with community leaders allows us to work with those who know the community best. Community-based organizations and places of worship are also good places to work with to reach older Latinos. If we explain to them about Medicare fraud and how it affects the community, they will help us. We all care about the community and we can work together to prevent Medicare fraud. Another key partnership is with members of the media.

Both the mainstream media and Latino community are important, but the Spanish-language media is considered part of the community. Older Latino adults look at many members of the Latino community as honest people they respect to give them the news and to help the community. At NHCOA, we have found that inviting a reporter or news anchor to a community event has been very effective. Whenever that happens, we get a lot of people to come and listen, because these members of the media are well known and well respected in the community.

Establishing relationships with members of the Latino media is a very good and very effective way to inform the community about Medicare fraud and why they should care.

Members of the Latino press are a good channel for information.  When we work with members of the Latino press, the reporter has a buy-in. This is a community of partnerships, of relationships, of friendships, and if we ask everyone to talk about Medicare fraud prevention, we are creating momentum. If we could get a television news personality to take the flag on Medicare fraud prevention, the campaign would be very successful. Television programs and Spanish-language community newspapers are good outlets, but probably the most effective media outlet in the Latino community is the use of radio, and it’s a medium we don’t use nearly enough.

Radio is a big part of an older Latino’s daily life, and it’s about putting together a PSA and sending it out to stations. It’s about going on local radio programs, talking about the importance of Medicare fraud and giving listeners the opportunity to call-in and ask questions about it. Local radio programs have been a very effective way to reach the community. Whenever we’ve used radio, the phones have been ringing off the hook with people seeking answers. We’ve also found that it’s not a one-shot deal.

Repetition is the name of the game here.

It’s not about going on a radio show and leaving town to never come back, but rather to come on as many times as possible. Repetition, repetition, repetition. A very effective method is finding a news hook. Pay attention to the news. When Medicare scammers are arrested, for instance, that’s a good opportunity to talk about Medicare fraud and show older Latinos why it’s an issue they should care about.

We’ve also found that talking about other topics doesn’t mean that the issue of Medicare fraud won’t come up.

For example, at NHCOA we found that when we talked about the Affordable Care Act when it was rolling out, we had many questions about Medicare. Scammers don’t take a day off, and they were telling Latino seniors that under ACA, they had to change coverage, which is not true and that was causing a lot of confusion. By talking about ACA, we were able to clear up a lot of questions older Latinos had about Medicare and Medicare fraud. It’s also a good idea not to forget that because family is so important in the Latino community, making sure the message of Medicare fraud reaches members of an older Latino’s family is very important.

Additionally, making sure to include caregivers in any messaging is also essential, as it is oftentimes the caregivers who are making decisions for the older Latinos. When you create partnerships with community leaders, community-based organizations and members of the media, you create an effective way to talk to older Latinos, their families, and caregivers about Medicare fraud in a caring, respectful way and they feel they have a stake in the issue and would help make sure it doesn’t happen to them.

Feliz Año Nuevo: New Resolutions for 2014

ae25c3c389bab00310e593f279cd83ca741d828dAs the end of 2013 draws near, people around the world are getting ready to celebrate a new year. While traditions vary in different cultures – from eating grapes to kissing a loved one at midnight – one common tradition that people across many cultures share is making resolutions for a fresh start. This year the NHCOA family encourages you to adopt some new resolutions that will not only improve your life, but the lives of those around you too, including our padres y abuelitos.

  1. Get tested for HIV. The Centers for Disease Control and Prevention estimates that 1 in 4 people living with HIV don’t know they have it. One of the best ways we can achieve the goal of making an AIDS-free generation a reality is to stop the spread of HIV by practicing safe sex every time and getting tested for HIV regularly.
  2. Each year resolutions around weight-loss and increased gym attendance prevail. This year try adopting a healthy diet and doing physical activity, such as dancing or walking, in an effort to prevent or manage diabetes.
  3. Get vaccinated against the flu. The height of flu season arrives right after the new year, so it’s still not too late to get your vaccine. And while the flu vaccine may be one of the most well-known vaccines, you may need others. Discuss the vaccines you need with your doctor this year.
  4. Help fight Medicare fraud by becoming a volunteer for the National Hispanic SMP program. Scammers often target Hispanic older adults due to their unique vulnerabilities, including linguistic and cultural barriers, lower levels of formal education and social isolation. By getting involved with the NHSMP, you can help protect our padres y abuelitos from Medicare fraud and strengthen the program for future generations.
  5. Advocate for paid family leave in your state. Twenty years after the passage of the Family and Medicare Leave Act, only about 60 percent of U.S. workers have access to paid leave, putting a huge financial burden on new parents and those with sick family members.
  6. If you don’t have health insurance, sign up for a plan through the marketplace. NHCOA’s Navigators can help you as you decide which plan best meets your needs. In 2014, access to health insurance is no longer a privilege, but a right.

No matter the resolutions you pick, the NHCOA family wishes you a happy and healthy Near Year! Feel free to share your resolutions in the comments section below.

It’s Time: Medicare Open Enrollment Begins Today!

Medicare-Open-Enrollment-Logo_-NHSMPIt’s time: Medicare Open Enrollment begins today! Medicare Open Enrollment is the time of year when beneficiaries can change their Medicare health plan and prescription drug coverage for the following year. Each year Medicare Open Enrollment runs from October 15-December 7. The National Hispanic Council on Aging (NHCOA) encourages you to consider reviewing your Medicare drug or health care plan, and/or assist your loved ones in reviewing theirs. You can use the materials provided in our Medicare Open Enrollment toolkit to assist you in reviewing your options in order to find the coverage that best meets your needs. However, if you and your loved ones are satisfied with your current health plan, no action or change is required.

Medicare is health insurance for people 65 years or older. The U.S. Federal government provides this health care service from revenue collected through payroll taxes. If you’ve paid into Social Security and Medicare for 10 years as an employee, you are most likely eligible for Medicare benefits.

Following the three C’s is a good criterion to keep in mind when reviewing current plan and making the decision whether or not to make changes.

  • Cost: Evaluate your current health care costs and find the coverage that works with your budget.
  • Coverage: It’s important that the services and care you will need in the coming year are covered by the plan you choose.
  • Convenience: Make sure the plan you choose fits your lifestyle.

Be informed. Making changes to a Medicare plan is a personal choice based on each beneficiary’s health needs and preferences. No one should pressure beneficiaries to make a decision that they are not comfortable with. In fact, soliciting or pressuring seniors to switch or change their Medicare drug or health care plan is against the law.

Medicare fraud usually heightens during open enrollment because scammers often prey on older adults’ uncertainty of how to navigate the system during open enrollment. Furthermore, in light of the overlapping open enrollments for Medicare and the Affordable Care Act’s Health Insurance Marketplace, more fraud is expected this year than in the past.

Consequently, NHCOA also encourages Hispanic older adults, their families, and caregivers to be aware of potential scams during Medicare Open Enrollment and join the efforts of the National Hispanic SMP program. The NHSMP is dedicated to helping Latino seniors across the country protect, detect, and report Medicare fraud. To learn more about the National Hispanic SMP, visit NHCOA’s website:www.nhcoa.org/medicare or call 1-866-488-7379.

The best way to compare and review Medicare plans is by using the Medicare Plan Finder, an online comparison tool available at www.Medicare.gov, or by calling toll-free 1-800-MEDICARE (1-800-633 4227).

How the Affordable Care Act Affects Your Medicare

Tomorrow, October 1st, will usher in a new era of health insurance in the U.S. with the opening of the Health Insurance Marketplace. The Marketplace is the result of the Affordable Care Act (ACA), which was passed in 2010 and requires most Americans to have health insurance. Through the Marketplace, consumers can find quality health coverage that meets their unique needs.

As with any major change, the ACA has spurred many questions from people, both with coverage and without coverage. Some seniors, who may already be covered by Medicare, have expressed confusion by how the ACA will impact their coverage. As a result, Medicare.gov – the official U.S. Government site for Medicare – created a list of the top five things to know about the ACA for those with Medicare:

  1. Your Medicare coverage is protected. Medicare isn’t part of the Health Insurance Marketplace established by ACA, so you don’t have to replace your Medicare coverage with Marketplace coverage.  No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now. You don’t need to do anything with the Marketplace during Open Enrollment.
  1. You get more preventive services, for less. Medicare now covers certain preventive services, like mammograms or colonoscopies, without charging you for the Part B coinsurance or deductible. You also can get a free yearly “Wellness” visit.
  2. You can save money on brand-name drugs. If you’re in the donut hole, you’ll also get a 50% discount when buying Part D-covered brand-name prescription drugs. The discount is applied automatically at the counter of your pharmacy—you don’t have to do anything to get it. The donut hole will be closed completely by 2020.
  3. Your doctor gets more support. With new initiatives to support care coordination, your doctor may get additional resources to make sure that your treatments are consistent.
  4. The ACA ensures the protection of Medicare for years to come. The life of the Medicare Trust fund will be extended to at least 2029—a 12-year extension due to reductions in waste, fraud and abuse, and Medicare costs, which will provide you with future savings on your premiums and coinsurance.

The ACA is important to the wellbeing of Americans, and will transform health care from a privilege into a basic human right. However, some scammers are taking advantage of seniors’ confusion about how the ACA affects their Medicare, resulting in a new crop of Medicare fraud.

The National Hispanic Council on Aging’s (NHCOA) National Hispanic SMP (NHSMP) can help older adults and their loved ones during this time of uncertainty. The NHSMP is the only Medicare fraud prevention program that uses culturally and linguistically appropriate tools and resources to close the gap in Medicare fraud education among Hispanic older adults, their families, and caregivers. NHSMP also provides technical assistance to organizations working with older adult populations, so they can more effectively expand their reach to Hispanic seniors, while meeting the demands of our increasingly diverse older adult population. For more information, please visit the NHSMP website.

The 48th Anniversary of Medicare and Medicaid

President Johnson signing Medicare and Medicaid into law on July 30, 1965.
President Johnson signing Medicare and Medicaid into law on July 30, 1965.

Today marks the 48th anniversary of President Lyndon B. Johnson signing Medicare and Medicaid into law. At the time this law was signed, millions of Americans and approximately half of the country’s older adults did not have health care coverage, were unable to afford basic health care services or weather a medical emergency. In the nearly five decades since their inception, these programs have ensured that our nation’s older adults and most vulnerable have access to affordable health care. While Medicare and Medicaid were created together and are often referred to collectively, the programs each serve a unique purpose.

Medicare is a health insurance program offered by the federal government that helps eligible individuals pay for health care. Those who are eligible include individuals who are ages 65 and older; certain persons under 65 with disabilities and individuals with end stage renal disease. Medicare has four parts:

  • Part A: which covers hospitalization
  • Part B: which is health insurance
  • Part C: which includes Medicare Advantage plans – a combination of hospitalization coverage and health insurance (like HMOs and PPOs)
  • Part D: which covers prescriptions

Medicaid is a separate program that receives federal and state resources to help low income individuals cover their medical expenses. Some individuals are eligible for both Medicare and Medicaid. Medicaid is different in each state, which is why it’s important to contact your local office to obtain information and program benefits in your state.

Both of these programs are essential in caring for our fellow compatriots. However they have often been compromised due to health care fraud. Medicare fraud in particular is pervasive, robbing an estimated $60 billion each year from our older adults and taxpayers. While Medicare fraud affects everyone – from our padres y abuelitos (parents and grandparents) to our young taxpayers – Hispanic older adults are at a higher risk of being targeted by fraudsters due to their linguistic and cultural barriers, social isolation, lower income levels and lower education levels.

As a result, the National Hispanic Council on Aging (NHCOA), with the support from the Administration on Aging, is working to protect our Hispanic older adults through the National Hispanic Senior Medicare Patrol (NHSMP) initiative, an offshoot of the federal government’s anti-Medicare fraud program.  The NHSMP Medicare fraud prevention campaign uses culturally and linguistically age-appropriate tools and resources to inform the community on how to detect, protect and report Medicare fraud.

NHCOA encourages everyone to work together to preserve the promise that we made to our older adults and other vulnerable individuals 48 years ago today – that Medicare and Medicaid will be protected so that they enjoy the best possible health.

The Affordable Care Act Prompts New Medicare Fraud

Later this month, Medicare and Medicaid will celebrate 48 years of helping people across the country access affordable health care. While Medicare and Medicaid have helped countless people over the years, scammers have often used these programs as a means of targeting our society’s most vulnerable through health care fraud.

Medicare fraud in particular is not new, and thanks to increased federal and lay vigilance, many scammers and their corresponding schemes have been shut down.  However, scammers are constantly developing new methods to manipulate the system. One common thread in today’s new Medicare fraud schemes is incorporating the Affordable Care Act (ACA). Since ACA passed in 2009, a new crop of scams have popped up and prey on seniors’ uncertainty concerning the legislation’s changes to Medicare.

Among this new generation of Medicare fraud are three common schemes:

1. New federal health insurance card: In this scam, fraudsters call seniors and tell them that they are among the first to be selected to receive a new federal health insurance card under ACA. However, in order for the card to be issued, the senior must provide personal information, such as their social security and bank account numbers.

Reality: There is no national health insurance card. The scammers are using the mandate requiring all Americans to have health insurance as a way to intimidate seniors and scare them into divulging their personal information to receive this fraudulent health insurance card.

2. Telemarketing scams: Fraudulent telemarketers take advantage of Medicare Open Enrollment season coinciding with health insurance exchange enrollment. By using terms such as “Obamacare,” fraudsters prey on seniors’ uncertainty of ACA changes.

Reality: Few changes were made in regards to federal health care for seniors. The insurance exchange does not impact Medicare in any way.

3. Fake websites: Many fake websites proclaiming to sell “Obamacare” are popping up online and asking for seniors’ personal information.

Reality: If you or a loved one needs information regarding health insurance exchange, only use the government’s dedicated website: www.healthcare.gov. Conducting a general internet search may result in a slew of fraudulent websites.

Perhaps most importantly, it’s crucial to always verify the identity of any solicitors before giving personal information, especially during this time of new Medicare scams.

As a result of Medicare fraud, and its disproportionate impact on Hispanic older adults, the National Hispanic Council on Aging developed the National Hispanic Senior Medicare Patrol – a Medicare fraud prevention program that uses linguistically, culturally and age-appropriate outreach and education to help Hispanic older adults to detect, protect and report fraud. If you suspect that you or a loved one has been a victim of Medicare fraud, please call 1-866-488-7379 or visit http://programs.nhcoa.org/medicare/ for more information.

Stories from the Field: Medicare Fraud in South Florida

This week, the National Hispanic Council on Aging (NHCOA) is hosting its annual Regional Meeting in Miami, FL. While in Miami, NHCOA team members met with staff from its local affiliate, Abriendo Puertas – a community-based organization that provides resources and services to the Little Havana neighborhood, including anti-Medicare fraud education through the National Hispanic SMP (NHSMP).

This service is particularly important in South Florida since Miami has long been known as ground zero for Medicare fraud, finding itself at the center of major fraud busts that garner national headlines. There are several factors that make Miami a prime location for scammers, including its high population Medicare beneficiaries and Hispanics.  In fact, studies show that scammers target populations that are affected by poverty, lower levels of formal education, cultural and linguistic barriers, and social isolation. As a result, Hispanic older adults are among the most vulnerable to Medicare fraud. Therefore, the work that Abriendo Puertas accomplishes through NHSMP is critical for our community in South Florida.

While the Abriendo Puertas staff has seen many scammers disappear and an increase in victims reporting Medicare fraud, they concede that it is still a serious and wide spread issue that affects our padres y abuelitos (parents and grandparents) on a daily basis. For each fraudulent pharmacy or medical practice that shuts down, another one pops up in its place. In fact, there is a fraudulent health care agency that recently opened near Abriendo Puertas, resulting in an ironic contrast between scammers and those who work to stop them.

The agency’s purpose is to enroll Medicare beneficiaries in their fraudulent health care program, cancelling their current Medicare plans and leaving them without the ability to receive crucial benefits. In order to carry out this scam, the agency takes advantage of the economic insecurity that many Hispanic older adults face. A recent report showed that 70.1% of Hispanic older adults live of the verge of poverty – the highest of any racial/ethnic group in the U.S. Aware of this fact, the scammers offer the beneficiaries much needed money to enroll in fraudulent health care plans. Since many live in poverty and are forced to choose between food, medication or housing, this extra money can be the difference between going to bed hungry and eating a filling dinner. In addition to this “signing bonus,” the agency attracts new clients by offering access to its beauty salon and gym.

Competing with scammers that offer such attractive incentives can be difficult for anti-Medicare fraud advocates, especially because suspicions alone are not sufficient. When reporting Medicare fraud, it’s necessary to provide proof in order for the legal system to address it.

However, one of the best tools we have in the fight against Medicare fraud is our community because we are our own best advocates. Therefore, NHCOA developed the National Hispanic SMP program, which seeks to make Medicare fraud prevention a family affair. The NHMSP works to train volunteers in local communities across the country on how to prevent fraud. Additionally, the program provides education and outreach efforts to Medicare beneficiaries in a linguistically, culturally and age appropriate manner. Overall, the NHSMP exists to educate and empower individuals to detect, protect and report Medicare fraud. For more information about Medicare fraud and the NHSMP, please visit the program’s website.