(It happens in NC, not just Minnesota)
By Gordon Allison | Reporter
ARAPAHOE – This past week, I received a mailing from Centers for Medicare & Medicaid Services (CMS). That letter had a headline printed in bold type that said my current Medicare card was no longer valid. I was somewhat surprised that it contained another new Medicare card. Another Medicare card? Yes, my first one was compromised during the Covid 19 fiasco. My wife’s card had been compromised too so we both got new cards in the fall of 2024. In fact, she received two new cards within two weeks. Further down in last week’s CMS letter, I was told not to use the newly enclosed card until April 14. Of course, this prompted my call to Medicare to clear up my confusion regarding what to do in the interim period. That call to a CMS agent took only about one minute around 5:30 pm on a Monday.
The agent (man) spoke what I call good, old-fashioned American English. He told me that the verbiage saying my old card was no longer valid was WRONG and that I should continue to use my old card until April 14. In my follow-up call to Medicare the next morning (in which I cited the instance of Covid 19 fraud) my wait time was just three minutes. The CMS agent didn’t put me on hold to ask someone else about it or to transfer me to another agent. How cool is that!? Then I asked the $64,000 question, “What happened to my account? Imagine this — without consulting anyone, he said, “Your account was hacked by one or more of 113 hackers who committed Medicare fraud. They got $13 Billion dollars total.” And unbelievably to me, the CMS agent also said, “We got them and recovered almost all of the money!” Yay!
I learned that Medicare notifies our supplement insurance carrier of any fraud that is found. A subsequent call to our supplement insurance carrier disclosed they rarely pay fraudulent claims due to in-house computer data checks, and they do go after the fraudsters when necessary. We are impressed!
We have always looked closely at the CMS reports to see our status on having to pay for medical services, as well as possible fraud. Covid times really ramped up the fraud in which we spotted once or twice weekly deliveries of the Covid test kits – 16 at a time. We dutifully reported the fraud to Medicare and filed the reports over the phone. We usually called around 10 or 11 PM to avoid being put on hold for one half to one hour. In one incident, Medicare called us back and reported they had investigated and verified the fraud and that the company was pursued for restitution. That call came about three years after we filed the report. With another fraud case in 2024, I was supposed to have undergone 13 gene tests in Denver – dates of the tests were after we had moved to North Carolina some eight years earlier! Medicare denied six of the gene tests to the tune of $1,785. The seven remaining gene tests that Medicare paid totaled almost $3,000, some of which were for Franconi Anemia, Breast Cancer, Bloom Syndrome, and Cystic Fibrosis.
Here is a short guide for you to assist Medicare. Review the Medicare Summary Notice when it arrives in your mail. Look on page three to begin. Be sure all claims were actually yours. If you find claims that are fraudulent, highlight them and call Medicare (800-633-4227) to report the fake claims. Medicare may ask a few questions to clarify the situation. Medicare will automatically contact your supplement insurance company to report the fraud. Our insurance company indicates they also have a computer program that does a search to ward-off fraud – catching most of the problems before payments are made.
Gordon is a frequent contributor to The County Compass
