For Professionals: Medicare fraud and abuse

Telephone Scams in California Continue – Protect Your Medicare and Credit Card Info

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Published: July 1, 2008

Have you been offered a new Medicare card with dental, vision, and hearing aid benefits? If so, this offer may be one of the recent telephone scams being made to beneficiaries around the state and nationwide. In this particular scam, callers often ask for beneficiaries’ credit card number in exchange for mailing a new Medicare card with these ‘extra benefits.’ Many callers claim to be from a fictitious ‘National Medical Office’ in Washington D.C., yet when traced are from Canada or other international locations.

Several of California’s Health Insurance Counseling & Advocacy Programs (HICAPs) have reported this telephone scam. Orange County HICAP worked with their local fraud agency to track the callers, yet have found that these calls are increasingly untraceable. In a growing number of cases, the scam artists are setting up “boxes” along the phone line routes so that the investigators can’t trace where they are calling from.

With little recourse to track down these scammers, people’s best defense is to be alert for such calls and to never give out one’s personal credit card or Medicare information over the phone to a stranger. In addition, remember that Medicare does NOT perform such ‘cold calls’.

Being familiar with what Medicare health plans CANNOT do when marketing their plans also helps Medicare beneficiaries protect themselves from becoming victims of such telephone scams. For example, Medicare health plans CANNOT:

  • enroll you over the telephone if they call you;
  • ask for your financial or personal information if they call you;
  • request payment over the telephone; or
  • disregard the National Do-Not-Call Registry and “do not call again” requests.

They also CANNOT:

  • visit you in your home or nursing home room to endorse a Medicare-related product without an invitation; or
  • provide gifts or prizes worth more than $15 to encourage you to enroll;
  • send you unsolicited e-mails;
  • compare their plan to another plan by name in advertising materials;
  • include the term “Medicare Endorsed” or suggest that it is a ‘preferred’ Medicare plan; or
  • use information that they have obtained from you to market non-health-related products and services without your written consent.

If any of these actions occur, you can report fraud to a Senior Medicare Patrol counselor at your local HICAP office by calling 1-800-434-0222. In addition, if you receive a call from a telephone scammer, make sure to record who you spoke with, the date and time of the call, the information given to you, and the outcome of the call. You can also report suspected fraud to:

If the suspected fraud is with a Medicare health plan, send a formal grievance to the plan whose agent committed fraud and send a copy to both the plan’s manager at the Center for Medicare and Medicaid Services’ (CMS) regional office and to California’s SMP office. If you’re emailing your grievance, you can ‘cc’ Julie Schoen, SMP Project Director at .

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