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Home Health Care Fraud in South Carolina

Be Aware of Common Scams

health care fraud

Every year, the FBI monitors industry fraud trends, and for the past decade or so, more and more cases of home care financial fraud have been reported. While all health care programs are subject to fraud, the most popular are Medicare and Medicaid. Each year, millions of dollars from these programs are paid to home health care companies for services that either weren’t necessary or were never provided.

Around $3 trillion in heath care expenditures are recorded every year, and according to the FBI, it’s estimated that between 3 percent and 10 percent of this total is fraudulent billings. These scams can be found anywhere, from public health care companies to private health care companies to beneficiaries, and in short, it’s the taxpayers that are being taken advantage of.

Common Scams

Many times, a personal care assistant or home care company will exaggerate the amount of service they have provided for a patient or will report the services they provided, but never follow through with them.

In other instances, these assistants or companies will embellish the level of service they have provided (choosing a more expensive level) or will even double-bill both a program like Medicare or Medicaid and a private insurance company.

Because Medicare and Medicaid don’t physically monitor these health care professionals, they are unaware if the services reported are correct, and will pay the proposed bill in good faith. Meanwhile, the health care patient is oblivious to the scam.

How to Protect Yourself

According to South Carolina’s Senior Medicare (Fraud) Patrol, Medicare and Medicaid beneficiaries should:

  • Treat Medicare, Medicaid and Social Security numbers like a credit card number. Never give out account numbers or other personal information to strangers.
  • Remember, Medicare representatives DO NOT make uninvited home visits or call to sell a prescription drug or health plan.
  • Review the summary notice (MSN) to look for charges for services or products that were not provided.
  • If the medical equipment or service is “free”, be suspicious; ask questions before providing the Medicare/Medicaid number.

At New Generations, we stand firmly against home health care fraud and will never take advantage of our patients. For more information, talk to our South Carolina home health care company or visit the South Carolina Office on Aging.