National Data Breaches Lead to COVID Test Kit, Catheter Medicare Fraud

Last year, many Iowa Medicare beneficiaries were surprised to learn that COVID test kits—whether they turned up on their doorstep, or on their Medicare statements—were a symptom of compromised Medicare numbers. Formally known as Medicare Beneficiary Identifier (MBI), your Medicare number is unique to you, is as important as your Social Security Number (SSN), and as valuable as a credit card number. Reading your Medicare statements, also known as Medicare Summary Notices, is one easy way to detect and help prevent future fraud. 

If you suspect a claim to be fraudulent, it’s best practice to contact the provider and let them know that there is an error. If the billing office refuses to reimburse your account, contact Medicare to report the claim. Medicare will send a letter to the provider and give them 65 days to reimburse, before taking further action.

One step you can take immediately is to contact Medicare after finding a claim or charge that you don’t recognize. In the case of the hundreds of Iowans that found charges on their MSNs for COVID test kits that they didn’t order, it wasn’t as simple as pointing out a billing error to a provider. “Folks were contacting these companies that charged them for COVID test kits they didn’t order and then realized that the phone number was not active, or it required them to leave a message, and never heard from the providers,” says SMP Caseworker, Marlú Abarca. “Through our interviews with Medicare beneficiaries, we learned that their MBIs were compromised through several data breaches, including but not limited to Aetna, Maximus, and even IMB.” 

Once you have reported a suspicious claim to Medicare, you must also request a new Medicare Number to prevent further fraud from occurring. But that isn’t enough, Abarca explains, “It’s not enough to just report the claim to Medicare. This is because scammers who acquire MBIs will also turn around and sell it to the next scammer. That’s why many beneficiaries were seeing multiple fraudulent providers on their MSNs.”

Iowa SHIIP-SMP is made up of certified volunteer Medicare counselors who are familiar with the Red Flags of Fraud. Last Spring, SHIIP-SMP was able to train 5 SHIIP Counselors as Senior Medicare Patrol (SMP) Specialists, just in time for the flurry of COVID Test Kit complaints. “SMP Specialists are essential to preventing, detecting, and reporting fraud,” explains SHIIP-SMP Director, Kristin Griffith. “Our SMP Specialists are trained to help beneficiaries, their families, and their caregivers report fraud to Medicare and request new Medicare numbers,”  Find a SHIIP Counselor near you.