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New York StateWide Senior Action Council Announces It's Medicare Fraud of the Month: Telemedicine Fraud


News provided by

New York StateWide Senior Action Council, Inc.

Aug 16, 2022, 07:00 ET

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ALBANY, N.Y., Aug. 16, 2022 /PRNewswire/ -- New York StateWide Senior Action Council (StateWide), an organization dedicated to advocacy for the rights of seniors in New York State today announced its Medicare Fraud of the Month for August; Telemedicine Fraud.

"Telemedicine Fraud, often called Telehealth Fraud is a growing trend in Medicare. The COVID-19 pandemic created unprecedented challenges for how patients accessed health care with the need for social isolation leading to an explosion in remote Telemedicine care," stated Maria Alvarez, Executive Director of StateWide in announcing this month's Medicare Fraud of the Month.

The StateWide Fraud of the Month is a component of the Senior Medical Patrol, the definitive resource for New York State's senior citizens and caregivers to help detect, prevent, and report Medicare fraud and waste. StateWide is New York's grantee/administrator for this Federal Program.

Alvarez continued, "Patients can receive a wide range of Telemedicine services, including check-ins with their primary care providers, mental health care, and specialty services. Similarly, telehealth can be provided through a wide range of technologies, including video chats, remote patient monitoring devices, and phone calls."

How Telemedicine scams typically operate:

  • There are some common characteristics of these fraud schemes.
    • For example, telemarketers contact Federal health care program beneficiaries to solicit identifying information related to an individual's health conditions and health insurance number

  • A purported Telemedicine company then pays a medical provider to review records and electronically sign orders or prescriptions for medically unnecessary durable medical equipment, genetic testing, or prescription medications.

  • The medical provider typically does not interact with or otherwise treat the Federal health care program beneficiary prior to ordering the medically unnecessary items and services

  • A durable medical equipment (DME) company, laboratory, or pharmacy subsequently purchases the complete paperwork package that includes the Federal health care program beneficiary's information and medical provider's order or prescription, and submits false claims for payment to Medicare, Medicaid, and other Federal health care programs.

It is estimated that Medicare fraud costs New York taxpayers over $5 billion dollars a year. To help combat this illicit industry StateWide earlier this year announced its Fraud of the Month program to highlight these scams being perpetrated on the State's seniors.

If you suspect Telemedicine or any Medicare fraud, immediately call our Senior Medical Patrol Hotline, at 800-333-4374 or visit the StateWide website, www.nysenior.org.

SOURCE New York StateWide Senior Action Council, Inc.

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