FBI Warns About Hospice Scams Targeting Senior Citizens In Houston; How To Avoid Such Medicare Scams

The Federal Bureau of Investigations is warning the residents of Houston about a new medicare scam that is signing people up for hospice care without their knowledge or consent. The warning comes after the FBI received numerous complaints from victims in the area. Citing a huge increase in complaints, the FBI also issued some safety guidelines for residents, in an ABC13 news report.

Here's how the hospice scam unfolds

The hospice care scam was called a little bit more egregious and distasteful than typical medicare fraud by FBI Supervisory Special Agent Shannon Brady in an ABC13 News report. According to Brady, fraudsters are mostly signing up elderly victims for Medicare's $22 billion per year end-of-life hospice care even when they don't need it. In most cases, the victims don’t even know about it.

Once the scammers sign up the victims, they typically bill their insurance “thousands or even tens of thousands of dollars” even before the victims realize it. Furthermore, when the victims try to get on hospice after their health starts to decline, they are unable to do so with the provider of their choice as the fraudulent company has already signed them up for another program.

Brady warned in the report that the fraud has long-lasting effects, including constant denial of lifesaving care when the victim is in need. She added that the fraud is operated by a company and a doctor is also involved. The doctor helps the company in committing fraud along with sales and marketing representatives who are called ‘recruiters’ as they pursue victims and find the patients.

FBI’s tips on avoiding the scam

1. The FBI urges citizens to not share personal or medical information with strangers and to avoid taking calls from people who ask for such call information.

2. The FBI recommends people hang up such telemarketing calls and report such calls or scams to the FBI on its online portal.

Action against hospice fraud

Last year, Medicare dropped the hammer on such frauds and warned nearly 400 hospices are at risk of being kicked off the program unless they prove they're a legitimate enterprise. The Centers for Medicare and Medicaid Services cited the growing popularity of fraudulent schemes that claim to provide hospice care for patients who are not terminally ill.

The CMS announced that it will increase oversight of claims from newly enrolled hospices in Arizona, California, Nevada, and Texas, which were named as the hotspots for potentially fraudulent actors, Axios reported. Over the past couple of years, Congress has also approved several changes in the hospice survey and oversight process.

Verdict on recent hospice scam

Last month, the owner of two California-based hospice companies, along with a biller and consultant, was sentenced for a hospice fraud scheme that stole over $9 million from Medicare. In the fraudulent scheme, Akhsharumov concealed his ownership and control over the hospice entities from Medicare, and inserted nominee owners, while paying kickbacks to patient recruiters.

As per the court documents, from January 2018 to May 2021, Gayk Akhsharumov of Glendale made false and fraudulent claims for hospice services. He was sentenced to one year and one day in prison and ordered to pay $9,185,211 in restitution.