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Fraud Fighters Focusing on Medicare

Volunteers educate communities on financial scams, fraud prevention

When Cheryl Kelly of Schofield visited clients' homes for her job as a bank trust officer, she cringed when she realized that their financial documents weren't kept in a secure place.

See also: The high cost of Medicare fraud.

"I felt the need to educate people and encourage them to take responsibility for their financial lives," said Kelly, 66, who retired in 2010 after 37 years in banking.

About six years ago, Kelly joined the AARP Wisconsin Fraud Fighters, volunteers who are trained to present information on frauds and scams and how to avoid becoming a victim. Fraud Fighters have given presentations all over the state since 2006 and have spoken to a variety of groups ranging from union members to women's church groups.

Kelly and her 20 fellow volunteers discuss identity theft, medical identity theft and charity fraud. This spring, the Fraud Fighters are adding information about Medicare fraud prevention to their presentations.

Medicare fraud costs the system an estimated $60 billion each year and contributes to higher health care costs. Scams using the names of federal agencies to fool consumers are on the rise and are particularly dangerous to seniors, who tend to be more trusting, said Sandy Chalmers, administrator of the state Division of Trade and Consumer Protection.

Here are a few examples of Medicare fraud and what experts recommend consumers do to prevent it:

A health care provider or supplier billing Medicare for services or equipment never received.

Carefully check your Medicare statements. If you see a questionable charge, notify your provider or call Medicare directly.

Someone stealing a Medicare card to get treatment, supplies or equipment.

Leave your Medicare card at home unless you need it for the doctor or pharmacist, and shred old, unneeded Medicare forms or other health insurance documents.

Companies using false information to persuade someone to join a Medicare Advantage plan.

"Take your time to decide — a high-pressure sales pitch is usually a sure sign of a rip-off," Chalmers said.

Some people may feel immune to high-profile fraud cases like those in states like Florida or California, but that's not the case, said Sam Wilson, AARP Wisconsin state director.

Two years ago, the Wisconsin Office of Privacy Protection warned that Medicare beneficiaries across the state were getting calls from people impersonating Social Security Administration employees. The callers said they needed confidential information in order to reissue a Medicare card. Then, last November, people in northwest Wisconsin reported getting calls from someone claiming to be a Medicare or insurance company representative who asked for Social Security or bank account numbers.

The best way to avoid these types of scams is to refuse to provide or confirm any personal information to anyone over the phone. Instead, call the Medicare number on the back of your card to verify that the representative is legitimate.

The work of groups like the Fraud Fighters is invaluable because educating people about fraud aids in prevention, Chalmers said. "Informed consumers are better equipped to identify fraud. Once you've become a victim, it's too late."

If someone falls victim to a scam, Fraud Fighter Marsha Konz, 67, of Mequon, encourages the person to report it. Often, victims feel embarrassed or think reporting is futile, but it does make a difference, she said.

"They might not identify the person who scammed you," Konz said, "but they can find trends. And then they can stop it from happening."

Each individual can make a small difference toward reducing Medicare fraud, Wilson said. Simple steps such as carefully reviewing health care bills or Medicare statements and reporting errors can add up.

"People can take positive steps. They can say, 'I'm doing my part to identify and curtail unnecessary spending, both in my pocketbook and in the nation's spending.' They can be part of a solution."

To request a presentation by an AARP Wisconsin Fraud Fighter for your organization, call or email Mariann Muzzi, director of the program, at 608-286-6303 or

For more information or to report a scam, contact the Bureau of Consumer Protection online or call 1-800-422-7128 or email

To report a fraud or check out the validity of a business or individual, visit the Division of Financial Institutions online or call 1-800-472-4325.

Amy Geier Edgar is a freelance writer living in Racine, Wisc.

Also of interest: AARP ramps up fight against Medicare fraud.

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