Fraud & Abuse
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Open Enrollment is Almost Here! Watch Out for Scams
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Medicare’s Open Enrollment (October 15 – Dec 7) is fast approaching. Be prepared for an onslaught of television commercials, radio ads, events, mailings, phone calls and texts. It can be overwhelming and hard to navigate, but the Centers for Medicare & Medicaid Services (CMS) has marketing rules for Medicare Advantage and Part D plans to…
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Increased Scrutiny for Hospice fraud – What’s happening in California
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In September, the Centers for Medicare and Medicaid Services (CMS) increased its oversight of Medicare’s hospice benefit in four states by expanding prepayment medical review in Arizona, California, Nevada, and Texas. To help reduce burden on compliant providers, CMS said in a statement that initial review volumes will be low and adjusted based on results. But…
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Tips on how to avoid New Medicare card scams
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Along with hospice fraud, new Medicare card scams are one of the top three types of reported Medicare fraud across the state. Watch out – these scammers do their homework and sound very professional! They may call, email or show up at your door unannounced and already know your name, address, date of birth, doctors names and/or other…
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What You Can Do to Protect Your Personal Information
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With several major data breaches having been reported in the media this year, the Social Security Administration (SSA) recently posted an article that reminds people of the importance of protecting their personal information. If someone illegally uses your Social Security number (SSN) and potentially assumes your identity, it can cause many problems. Below is SSA’s article with some important tips on what…
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Watch for Your Annual Notice of Change Document this month
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If you’re in a Medicare Advantage and/or Part D drug plan, you will receive an “Annual Notice of Change” (ANOC) and “Evidence of Coverage” (EOC) from your plan by September 30th each fall. The ANOC and EOC make reviewing your plan changes for 2025 easier, as all the changes are in these letters. They will…
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