Vol. 2, No. 24
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October 15, 2005
Nevada's Online State News Journal
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CRIMINAL DEFENSE |
COPYWRITING
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Potential Medicare Fraud Warnings Voiced By Attorney General And Social Security
New Prescription Drug Program Ripe For Fraud, According To AG's Fraud Patrol Unit
Attorney General Brian Sandoval warns Nevada seniors of the potential for fraud in the solicitation of seniors to participate in the new Medicare Part D prescription drug programs. Starting January 1, Nevada Medicare recipients will be able to choose between traditional Medicare prescription drug coverage or a Medicare Advantage plan that may offer drug coverage and other benefits. Representatives for these new Medicare Prescription Drug Plans were allowed to begin marketing to Medicare recipients on October 1 of this year.
In Nevada, 17 companies are approved to offer stand-alone prescription drug plans. Six organizations are approved to offer prescription drug benefits through Medicare Advantage plans (Medicare managed care). Each company can offer multiple plans, as long as all meet Medicare’s basic criteria for coverage and cost.
The concern, however, is that fraudulent companies may take advantage of the confusing nature of these plans, and trick seniors into giving out personal information or signing up for non-existent benefits. “We are concerned that some of these programs may try to sell unnecessary products to seniors, or worse, steal seniors’ personal information for fraudulent purposes,” said Jo Anne Embry, project director of Nevada’s Senior Medicare Fraud Patrol Project. “We want to educate consumers to become informed health care consumers before making a decision. That means knowing which programs are legitimate in Nevada and reporting any kind of suspicious activity from groups that aren’t approved in our state.”
The Medicare-approved, stand-alone Prescription Drug Plans in the state of Nevada include:
- Aetna Life Insurance Company
- Anthem Insurance Companies, Inc.
- Connecticut General Life Insurance Company
- Coventry Health & Life Insurance Company / First Health Life & Health Insurance Company
- Humana Insurance Company
- Marquette National Life Insurance Company / Pennsylvania Life Insurance Company
- Medco Containment Life Insurance Company
- Memberhealth, Inc.
- Pacificare Health & Life Insurance Company
- RxAmerica, LLC
- Sierra Health & Life Insurance Company, Inc.
- Silverscript Insurance Company
- Sterling Life Insurance Company
- Unicare
- United American Insurance Company
- United Health Care Insurance Company
- Wellcare Health Plans
The Medicare Advantage (Medicare managed care) plans approved to offer prescription drug benefits in the state of Nevada include:
- Sierra Health and Life Insurance Company, Inc.
- Health Plan of Nevada, Inc.
- Hometown Health Plan
- Humana, Inc.
- Pacificare
- Sierra Health and Life Insurance, Inc.
Consumer Advocate and Chief of the Bureau of Consumer Protection Adrianna Escobar Chanos joined with Las Vegas Mayor Oscar Goodman and other state, county and city officials to kick off a series of “Nevada Medicare Express” events across southern Nevada. The events will give seniors the opportunity to ask questions about how the new Medicare policy works and how to protect themselves from potential fraud.
The dates and locations for the events are:
- OCTOBER 21: Doolittle Community Center (Lake Mead & J), 9 – 11:30 am
- OCTOBER 25: Mountain Crest Community Center (Craig & Durango), 11 am – 1 pm
- NOVEMBER 2: Whitney Ranch Recreation Center (Boulder Hwy & Missouri), 9 am – 1 pm
- NOVEMBER 8: Cambridge Community Center (Cambridge & Swenson), 9 – 11 am
- NOVEMBER 10: Santa Fe Station (Rancho & Ann Road), 9 – 11 am
- NOVEMBER 15: Texas Station, 9 am – 1 pm
- NOVEMBER 16: Walnut Recreation Center (Cheyenne & Walnut), 9 – 11 am
- NOVEMBER 17: Charleston Heights Community Center (Charleston & Brush) 10 – 11:30 am
The Nevada Medicare Express is a collaborative effort among federal, state, local, non-profit and corporate partners whose purpose is to bring Nevadans the best information on Medicare’s new prescription drug benefit. The goal is to help consumers make an informed decision on whether the new benefit is right for them, how to choose the right plan for their prescription drug needs, how the plan affects existing drug coverage and the consequences of choosing not to participate.
Additionally, there are approximately 90,000 potential Medicare beneficiaries in Clark County that are eligible for extra help from the Social Security Administration (SSA) in paying their drug premiums and co-pays. This number represents the highest number of persons per capita in the nation. Therefore, Nevada’s public affairs specialist from SSA will be on site at each of the Medicare Express events to explain the extra assistance eligibility requirements and there will be volunteers on site to assist beneficiaries in signing up for this program.
The NDOJ is also working closely with the Nevada Department of Health and Human Services, which contributed $100,000 toward the Medicare Express events. The Senior Nevada Medicare Fraud Patrol is part of the Senior Nevada Advocates on Guard, or “SNAG,” which is a partnership of the NDOJ, the Nevada Division of Aging Services, the US Attorney's Office, and the AARP. The unit is comprised of a group of trained senior volunteers who are able to assist Nevada Medicare beneficiaries in understanding the delivery of their health care through the Medicare and Medicaid systems and how to spot and report suspicious activity. If you or someone you know suspect Medicare Fraud, please call the fraud patrol’s hotline at 1-888-838-7305.
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