Outpatient Mental Healthcare Fraud: "The Medicare Fraud of the Month for September"

ALBANY, N.Y., Sept. 14, 2026 /PRNewswire/ -- The New York StateWide Senior Action Council (StateWide), a 54-year-old non-profit organization dedicated to serving the needs and well-being of our State's more than 3.6 million senior citizens, today announced its Medicare Fraud of the Month for September: Outpatient Mental Healthcare Fraud.

The StateWide Fraud of the Month is a component of the Senior Medicare Patrol (SMP), the definitive resource for New York State's older adults and caregivers to detect, prevent, and report healthcare fraud, errors, and abuse. StateWide is New York's grantee/administrator for this Federal Program.

Maria Alvarez, Executive Director of StateWide, explains, "Medicare covers outpatient mental health care, including some telehealth services. Fraud can occur when Medicare is billed for services not received, didn't need, or were different from the care provided."

StateWide advises Seniors to be alert if:

• No Visit Occurred
  • Medicare is billed for a telehealth visit that never happened.
• Incorrect Time Billed 
  • Medicare is billed for a longer therapy session than received.
• Repeated Visits Appear 
  • A Medicare statement shows multiple telehealth therapy sessions that were never received.

Seniors need to check before they trust:

• Know who provides services.
• Understand why the service is needed.
• Keep track of all appointments.
• Never give a Medicare number to an unexpected caller.
• Review Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) for unfamiliar charges

Alvarez added, "If you see something on your Medicare statements that doesn't look right such as services not received, a provider not recognized or the services billed do not match the care received, contact the NYS Senior Medicare Patrol (SMP)."

The New York State Senior Medicare Patrol (SMP) can be reached at 800-333-4374 or by visiting www.nysenior.org. StateWide has trained counselors to help Medicare beneficiaries in the fight against Medicare fraud.

StateWide also provides information and educational presentations, assistance regarding any Medicare questions, plan comparisons, appeals, billing issues and patients' rights to all seniors throughout New York State.

It is estimated that Medicare fraud costs taxpayers over $60 billion dollars nationally per year. To help combat this illicit industry StateWide announced its Fraud of the Month program in 2022 to highlight these scams being perpetrated on the State's seniors.

SOURCE New York StateWide Senior Action Council, Inc.