Expanded Medicaid rolls lead to scam warning

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FRANKFORT, Ky. (WTVQ) – With more people on the state’s Medicaid rolls because of the coronavirus epidemic, state leaders are issuing warnings about scammers trying to take advantage.

During the COVID-19 pandemic, scammers may target Medicaid beneficiaries in order to illegally bill the Medicaid program for unnecessary services and equipment related to coronavirus testing and treatment, said Attorney General Daniel Cameron.

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Anyone who believes they have been a victim of Medicaid fraud during the COVID-19 pandemic should contact the state Medicaid Fraud and Abuse Hotline at 1-877-ABUSE TIP.

To profit from the current health crisis, marketing organizations, telemedicine companies, and labs may work together to solicit Medicaid beneficiaries for fraudulent COVID-19 testing.

The marketing organization may provide an illegal kickback to a telemedicine company in order for a provider to sign off on administering both a COVID-19 test and a Respiratory Pathogen Panel Test (RPP Test).

The RPP test is not required to test for COVID-19, but it allows the provider to bill the Medicaid program at a higher rate. Sites that administer testing using this illegal scheme often do not fully process the tests or provide beneficiaries with the results.

The following tips will help Medicaid beneficiaries avoid fraudulent COVID-19 testing sites:

  • If you experience COVID-19 symptoms, work with a licensed healthcare provider to determine if testing is needed. The Commonwealth’s COVID-19 website provides information on when to seek care for COVID-19.
  • Only use testing sites approved to test for COVID-19. You can contact your local health department to confirm the legitimacy of a testing site.
  • If a testing site offers additional testing beyond a COVID-19 test, check with your licensed healthcare provider to see if the additional testing is needed.

Scammers may also call or text Medicaid beneficiaries offering free COVID-19 testing and request the beneficiarys personal identification information (PII) under the guise of account verification. Scammers then use the stolen information to illegally bill Medicaid for medically unnecessary services or equipment, unbeknownst to the beneficiary.

To avoid becoming a victim of Medicaid fraud and identity theft, beneficiaries should:

  • Be suspicious of unexpected calls offering free COVID-19 testing.
  • Be cautious of unsolicited requests for your Medicaid number.
  • Never provide your social security number, Medicaid number, or credit card information to anyone other than a trusted source.

Suspected Medicaid fraud and scams should be reported immediately to the Attorney Generals Medicaid Fraud and Abuse Hotline at 1-877-ABUSE TIP.