Reading Help

NHCOA Celebrates Mothers on National Women’s Health Week

Washington, DC- Dr. Yanira Cruz, President and CEO of the National Hispanic Council on Aging (NHCOA)– the leading national organization working to improve the lives of Hispanic older adults, their families, and caregivers– made the following statement in commemoration of National Women’s Week, celebrated May 11-17, 2014:

“Mothers are the backbone of Latino families and as such NHCOA happily joins in the celebration of National Women’s Health Week to commemorate the important contributions of the women in our lives.

With implementation of the Affordable Care Act (ACA), millions more women now have access to preventive health services such as vaccinations, mammograms, Pap smears, and lower cost birth control. By creating a health environment that encourages healthier lifestyles, the ACA has primed families everywhere to take greater control of their health, particularly given that mothers tend to serve as the health decision-makers for their families.

Now that millions more have access to preventive health services, however, it is imperative that we as health professionals do our part to bridge the knowledge gap between diverse communities and the U.S. health system with which they may not be familiar. In addition to knowing how to use their new health insurance, mothers must be able to prevent and identify health care fraud and what their rights are as a patient. By working together to increase access to and appropriate use of health services, we can create healthier mothers and families for generations to come.”

###

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 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.

Hispanic Older Adults Are Among the Most Vulnerable to Fraud

Join NHCOA’s efforts to educate Hispanic older adults and caregivers on how to detect, prevent, and report Medicaid fraud

The National Hispanic Council on Aging (NHCOA) — the leading national organization working to improve the lives of Hispanic older adults, their families and their caregivers — is working to raise awareness and empower Hispanics to detect, protect, and report any sign of scam or fraud.

Generally, seniors are more likely to be victims of fraud than any other age group.  From phony lotteries to email schemes, fraud against seniors can take many forms and may result in identity theft, false records, and medical errors.  Scammers often take advantage of the fact that many older adults depend on Medicare for their health care needs. Hispanic elders, who are burdened by linguistic and cultural barriers, are particularly at risk.

Undoubtedly, Medicare fraud is one of the biggest scams targeting older adults in the U.S. today, and when our abuelitos are scammed, they are not the only victims. Everyone is affected by the Medicare fraud perpetrated by a few because the stolen money is collected from taxpayer dollars. As a result, each year billions of taxpayer dollars are lost to Medicare fraud.

With the support from the Administration on Aging (AoA), NHCOA 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.

As Hispanics grow to be the largest diverse aging group, the NHSMP program is recruiting and training Hispanic older adults, their families and their caregivers to learn about Medicare fraud and spread the word in the community to empower others to prevent, detect, and report Medicare fraud.

Several clients at Abriendo Puertas, one of NHCOA’s local partners that aids low-income residents in Miami, FL, have had experiences with fraud.  “I went to apply for public assistance at a service center, and they used my information to enroll me in a Medicare plan without my consent,” said Fransisco Ferrer, an Abriendo Puertas client.  “Because of this, I ran out of health services for three months. Thanks to the Medicare fraud prevention information that I received from Abriendo Puertas, I was able to resolve the issue and regain my tranquility. The National Hispanic SMP services are appropriate for my needs.”

In order to detect, prevent, and report fraud, it is important to be aware of its common signs.  You or your loved one has been a victim of Medicare fraud when:

  • You are charged for services that have been previously billed, or for services, screenings or medical equipment that were not received.
  • You receive products and services you do not need.
  • Someone has stolen your Medicare number.

Each scenario represents an act of abuse being committed against our seniors that compromises their wellbeing. These acts also lead to the theft of Medicare dollars, which subsequently hurts the taxpayer.

To report Medicare fraud and join the National Hispanic SMP program, call NHCOA’s toll-free hotline, 1-866-488-7379. Also visit www.nhcoa.org/Medicare/ for more information and additional resources. Remember that Medicare fraud prevention is a collaborative effort since it is a problem that affects us all, not just our seniors.

The Affordable Care Act Works: Winning the Fight Against Medicare Fraud

Note from NHCOA: The more informed you and your loved ones are regarding your health, the less likely you are to become a victim of health care fraud. With support from the Administration on Aging, the National Hispanic SMP (NHSMP) reaches Hispanic older adults, families, and caregivers to protect, detect, and report Medicare fraud in a culturally, linguistically and age appropriate manner. For more information, visit www.nhcoa.org/medicare.

Recently, the Departments of Justice and Health and Human Services hosted the 7th Regional Health Care Fraud Prevention Summit in Chicago, Ill. to highlight the new high-tech tools to fight health care fraud, as well as underscore the Affordable Care Act’s significant role in fighting Medicare fraud and the recovery of a record-breaking amount of funds.

For the second year in a row, the departments’ anti-fraud activities through the Health Care Fraud Prevention and Enforcement Action Team (HEAT) has recovered more than $4 billion. This is thanks to new tools provided through the Affordable Care Act, which include:

  • Tougher sentences for people who commit health care fraud
  • Expanding the search for waste, fraud, and abuse to Medicaid, Medicare Advantage, and Medicare Part D programs
  • Greater information-sharing capabilities between key government agencies, states, the Centers for Medicare & Medicaid Services (CMS), and law enforcement partners to suspend payments if providers and suppliers are suspected of engaging fraudulent activity.

In addition, the Affordable Care Act also directly helps Medicare beneficiaries by making it easier to detect, prevent, and report Medicare fraud themselves. The Medicare Summary Notices were recently re-designed to be more reader-friendly, which makes it easier for beneficiaries to detect and report discrepancies or errors, which could be a result of fraudulent activity.

The law also expanded funding for outreach education and engagement through the SMP (Senior Medicare Patrols) network, a national effort supported by the Administration on Aging to recruit and teach senior volunteers and professionals to help Medicare and Medicaid beneficiaries become better health care consumers.

As part of the SMP network, the National Hispanic SMP is dedicated to bring information and education to Hispanic older adults, their families, and caregivers in a culturally and linguistically appropriate manner to reduce the incidence of Medicare fraud in the community, which is disproportionately affected.

Having the tools and resources to identify and report Medicare fraud at the community level is just as important and necessary as investigating and prosecuting perpetrators of Medicare fraud because many times investigations are initiated based on tips from beneficiaries, local organizations who serve seniors, or the SMP network.

Everyone has a part to play in eliminating health care fraud, in particular Medicare fraud, so that this model system can continue serving older adults today and fulfill its promise to all generations of older adults who have contributed to the advancement of this country.

 

 

These are just some of the Obama administration’s efforts to combat health care fraud. Click here to see afact sheet.

 

For more information on the SMP network, click here.

 

For more information about the National Hispanic SMP, visit http://www.nhcoa.org/medicare.

National Hispanic SMP: Medicare Fraud is Still Biggest Scam Among Elders

Note from NHCOA: The more informed you and your loved ones are regarding your health, the less likely you are to become a victim of health care fraud. Through the National Hispanic SMP (NHSMP), NHCOA reaches Hispanic older adults, families, and caregivers to protect, detect, and report Medicare fraud in a culturally, linguistically and age appropriate manner.
Recently the National Council on Aging (NCOA) released a list of top ten scams targeting older Americans. Not surprisingly, health care fraud—which includes Medicare fraud—was Number 1.
Aside from being very lucrative, scammers turn to health care fraud because the scam itself takes time to unravel before it’s exposed and because the target population is vulnerable. This is particularly true for Hispanic older adults, who due to specific cultural and linguistic factors, are among the most at-risk segments of the older adult population.
However, new Affordable Care Act measures are ramping up efforts and cracking down on these wrong doers who bilk seniors, the Medicare system, and the U.S. taxpayer. Last year alone, $2.9 billion were recovered in health care fraud, of which $295 million was related to Medicare fraud.
Part of this work is thanks to the efforts of the SMP, a network of state entities that work to educate and empower seniors to protect, detect, and report Medicare fraud within their communities. Similarly, through the National Hispanic SMP (NHSMP), NHCOA reaches Hispanic older adults, families, and caregivers in a culturally, linguistically and age appropriate manner.
To learn how you can be part of the NHSMP, visit www.nhcoa.org/medicare to download tailored toolkit material or call 1-866-488-7379.

National Hispanic SMP: 2011 Sees Crackdown on Medicare Fraud, Increase in Medicare Benefits Through

Note from NHCOA: The more informed you and your loved ones are regarding your health, the less likely you are to become a victim of health care fraud. Through the National Hispanic SMP (NHSMP), NHCOA reaches Hispanic older adults, families, and caregivers to protect, detect, and report Medicare fraud in a culturally, linguistically and age appropriate manner.

In its second year of implementation, the Affordable Care Act (ACA) has made tremendous strides in curbing the waste, fraud, and abuse that plagues the health care system— in particular Medicare, a prime target for scammers— as well as improve benefits for patients, namely older adults.

Crackdown on Medicare fraud

In September 2011, Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebeliusannounced a nationwide Medicare fraud crackdown, which charged 91 people in 8 cities for about $295 million in false billing.

This adds to the total $2.9 billion the Justice Department recovered in health care fraud in 2011, as recently reported by Vice President Joe Biden.

The increased fraud arrests are partly due to new ACA measures, including longer prison terms for health care fraud and increased number of strike force teams specialized in this type of fraud. ACA also includes funding for technology that allows investigators to monitor for suspicious claim patterns before they are paid by the government.

In fact, the government will no longer implement the so-called “pay and chase” model with Medicare, which tracked fraudulent payments after they were made.

Increased benefits for older adults

Medicare beneficiaries saw several benefits kick in during 2011, including free preventive services and a prescription drug discount, which will help close the infamous “donut hole,” a long-existing gap between Part D’s traditional and catastrophic coverage.

Under the ACA, beneficiaries with Original Medicare (Part B) may qualify for a yearly wellness exam (check up) and certain screenings without a co-pay. Free counseling is also available if their body mass index (BMI) is over 30 as a means to decrease the incidence of chronic diseases such as cardiovascular disease and diabetes, which disproportionately affect diverse elders.

By the end of November 2011, CMS announced that more than 24 million seniors had taken advantage of these preventive services, which could potentially create significant long-term health care savings by allowing health care practitioners to detect programs before they become chronic or warrant hospitalization.

Seniors benefited from a 50% discount on prescription drugs to help close the “donut hole,” the gap between traditional and catastrophic coverage in the Part D drug benefit program. The law required drug companies to offer the discount to participate in the program. Through the end of October, more than 2.65 million Medicare recipients saved a total of $1.5 billion on their prescriptions. That’s an average of $569 per patient.

HHS announced in August that, as benefits have gone up for seniors, Medicare prescription drug plan premiums would go down an average of 76 cents in 2012 from 2011.

National Hispanic SMP: Delaying to File for Medicare Could Hurt Seniors Pockets

The more informed you and your loved ones are regarding your Medicare, the less likely you are to be a victim of Medicare fraud. Through the National Hispanic SMP (NHSMP), NHCOA reaches Hispanic older adults, families, and caregivers to protect, detect, and report Medicare fraud in a culturally, linguistically, and age appropriate manner.

The number 65 is a key number in Medicare terms. It is the age that a person to eligible to file for Medicare benefits. Given the economic downturn, there are increasingly more seniors who continue working past 65, some of who end up postponing filing for Medicare in fear of it hindering them.

However, it is all the contrary: failing to file for Medicare in a timely fashion will result in Part B monthly premium hikes—10% for each 12-month period that a senior could have been covered but wasn’t. The worst part is that penalty is permanent, resulting in unnecessary additional expenses at a time when every penny counts.

Seniors have a six-month window to file for Medicare, which starts three months prior to turning 65 and three month after. Those who have filed for Social Security benefits will automatically be enrolled in Medicare, but those who haven’t must enroll themselves at a local Social Security Administration office or online.

Note: Any person who turns 65 is eligible for Medicare even if (s)he can’t receive Social Security benefits.

To learn more, visit www.medicare.gov.