Wisconsin SMP In this issue:
Let’s Get Acquainted with Stan Whiteman, SMP Volunteer WI SMP Seeking Volunteers Statewide
Clinton Woman Sentenced for Social Security, Medicare, and Medicaid Fraud
Wisconsin Lags Behind Nation in Using Do-Not-Call List WI DOR to Quiz Tax Filers
DATCP Consumer Alert Florida Judge Halts Suspected Medical
Alert Device Scam Dozens of Retired NYC Workers
Accused of Faking Disabilities CMS News Release/New Regulations Save the Date for 2014 Triad Conference
SMP Activities
From the Project Director. . . Elizabeth Conrad
Let’s Get Acquainted
By Judy Steinke, Wisconsin SMP Volunteer Coordinator
Wisconsin SMP (Senior Medicare Patrol) is pleased to introduce Stan Whiteman of Baileys Harbor as our featured volunteer for January.
Stan heard the Wisconsin SMP public service announcement on the radio in the spring of 2011. His background and experience prompted him to contact our office and sign up to attend the SMP Volunteer Foundations Training.
Prior to retirement, Stan worked for various metal companies as the manager of human resources for 35 years. This gave him a great deal of experience in working with different types of insurance.
Stan grew up in a small, west central Illinois farming community and obtained a Bachelor of Arts degree from Monmouth College and a Masters in Business Administration from St. Ambrose University. He served in the military for two and one half years and began his working career with the State of Illinois.
Upon retirement four years ago, Stan and his wife, Jane, moved permanently to their vacation home in Door County. They have become active in the community, and he currently volunteers for his church, a thrift store that benefits a nonprofit senior living community, The Ridges Sanctuary and Nature Center, Door Tran (which provides transportation for Door County residents), and the Rotary Club of Northern Door County. Stan believes that it is important to give back to the community in which you live. Over the years, he has also volunteered for the United Way and various youth organizations.
Continued on page 2
2850 Dairy Drive Madison, WI 53718-6742
January 2014 Volume 17, No. 6 Coalition of Wisconsin Aging Groups Elder Law Center
Published and distributed by the Coalition of Wisconsin Aging Groups Elder Law Center funded in part by grant #90MP0187 from the Administration on Aging/Administration for Community Living, Department of Health and Human Services. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration on Aging Policy.
EDITOR AND PROJECT DIRECTOR Elizabeth Conrad
ASSOCIATE EDITOR Kevin Brown
This publication may be reproduced ONLY in its entirety. Permission to excerpt portions
must be obtained prior to use. © 2014 CWAG. All rights reserved.
F r a u d A l e r t !
Let’s Get Acquainted continued
Stan’s family includes three grown and married sons and five grandchildren who live in Illinois and Indiana. His hobbies include golf, travel, and woodworking projects. Recently, Stan purchased a new lathe, and he is looking forward to working on more turning projects.
Wisconsin SMP is thankful that you joined the team, Stan! We appreciate the work that you do in Door County, and we also thank you for your military service for our country!
Wisconsin SMP Seeking Volunteers Statewide
By Kevin Brown, Wisconsin SMP Capacity Building Grant Manager/Trainer
“Volunteering is a core American value. Americans who volunteer enrich our communities and keep our nation strong,” said Wendy Spencer, CEO of the Corporation for National and Community Service (CNCS). A report released last month by CNCS and the National Conference on Citizenship found that one in four Americans volunteered through an organization in 2012 and that volunteers age 65 and over spent a median of 90 hours on volunteer activities, the highest among any age group.
The report, “Volunteering and Civic Life in America,” found that more than 1.6 million Wisconsin residents volunteered through an organization in 2012. Wisconsinites contributed 165.3 million hours of their time to volunteer efforts, and their service was valued at $3.1 billion. Our state’s volunteer rate (35.6% of residents) ranked eighth among the 50 states and the District of Columbia. The study also found that 34.7% of Badger State residents who are over age 55 volunteered in 2012.
Wisconsin SMP (Senior Medicare Patrol) has recognized the great value that volunteers, particularly older ones, bring to our communities for a long time. We have dozens of dedicated volunteers, and they contributed 604.5 hours of service to our program in 2013. Our hard-working SMP volunteers make presentations to groups and distribute materials at community events across the state to educate Medicare beneficiaries, caregivers, and professionals about how to prevent, detect, and report
healthcare fraud, waste, and abuse.
Wisconsin SMP has a great group of volunteers, but we are always looking for new ones so that we can spread our message of fraud prevention to more people around the state. If are interested in becoming an SMP volunteer, please contact Wisconsin SMP Volunteer Coordinator Judy Steinke at (800) 488-2596, ext. 342 or [email protected].
Clinton Woman Sentenced for Social Security, Medicare, and Medicaid Fraud
Amira Avendano-Hernandez, a Clinton resident, was sentenced on December 17 to six months in prison for Social Security, Medicare, and Medicaid fraud. She was also ordered to pay $231,920.50 in restitution during sentencing in U.S. District Court in Madison. Avendano-Hernandez was accused of using another person’s name to obtain Social Security benefits on May 18, 2002 and submitting a second application for disability benefits using another name on May 27, 2005. She received
$66,457.50 in Social Security Disability Income between April 2005 and December 2011. Medicaid and Medicare also paid a total of $165,463 to various medical providers for her care.
Wisconsin Lags Behind Nation in Using Do-Not-Call List
According to statistics from the Federal Trade Commission released last month, Wisconsin residents were more likely to register for the national do-not-call list in 2013 than consumers nationwide, but a smaller proportion of Wisconsin consumers is registered on the list than in other states. Wisconsin consumers also filed the fourth-fewest complaints per resident about violations of the registry compared with other states.
Nearly 4 million phone numbers with Wisconsin area codes were registered on the FTC’s national do-not-call registry as of the end of September 2013, according to the agency’s 2013 National Do Not Call Registry Data Book, an increase of 3.1% from the end of September 2012. Wisconsin has lagged behind the national average in registrations on FTC’s list, based on population size, and is now No. 32 nationally. Nationwide, 223.4 million phone numbers were registered on the do-not-call list as of the end of September. The number of new registrations across the nation has been slowing in the past six years, from more than 27 million new registrations in 2008 to 5.8 million in 2013.
An analysis of the data by the Milwaukee Journal Sentinel shows Wisconsin caught up a bit in 2013 because a larger percentage of Wisconsin consumers registered for the list than residents of other states. By the end of September 2013, 69,728 numbers were registered per 100,000 Wisconsin residents — slightly below the national average of 72,257. However, registrations of Wisconsin area codes increased 2.8% in 2013, outpacing the national average of 2%.
Complaints to the FTC about calls that violate the national do-not-call list were down nationally in 2013. Consumers filed 5.2% fewer complaints about violations in fiscal year 2013 than they did in 2012. However, complaints from Wisconsin residents decreased 15.9%, over three times as much. Only three other states filed fewer complaints per number of residents: Alaska, Indiana and Hawaii. On October 16, new federal telemarketing rules took effect as part of the Telephone Consumer Protection Act. Previously, companies were also allowed to call if they had done business with the consumer in the past, but that exception no longer exists. Now, advertisers and telemarketers must have express written consent from the consumer to call, even if the person has done business with the company in the past. The company bears the burden of proving that the consumer consented.
The new law also entitles consumers to up to $500 to $1,500 in compensation per unsolicited call they receive — that is, calls from companies whom they have not been given unambiguous prior written consent to call. The amount of damages depends on whether the defendant “willfully” or “knowingly” violated the law.
“The new law makes robocalls obsolete,” said Jasmine Castro-Torres of the phone app PrivacyStar. “The problem is, no one is really aware of these laws, and most often feel they just have to ‘put up with it,’ which is not the case at all.” PrivacyStar is a free, subscription-based, phone app that provides caller ID and allows users to look up numbers, block calls and text messages, and file complaints with the FTC within the app. According to the company, nearly 10% of the do-not-call list complaints filed last year came through the PrivacyStar app.
While consumers may be able to get compensated for spam calls, it can be difficult to file complaints against callers. They can disguise the number they're calling from, either by providing a different number — often with a local area code, which is less suspicious-looking — or by hiding the number entirely.
Here are some do-not-call tips:
Register your number on the FTC’s do-not-call list at www.donotcall.gov or by calling (888) 382-1222. Registration is permanent.
Register your number on Wisconsin’s do-not-call list at nocall.wisconsin.gov or by calling (866) 9NO-CALL — that's (866) 966-2255. You have to re-register every two years to remain on the list. Deadlines are every quarter. The list is updated Jan. 1, April 1, July 1 and Oct. 1.
Don't answer calls from numbers you don't recognize.
Don't call an unknown number back to find out who it is. Instead, do an Internet search for the number. If you get a robocall, don't press any buttons or speak. Hang up. Pressing buttons or talking will just alert the callers that they have reached a working number.
Source: Milwaukee Journal Sentinel (January 1, 2014)
Wisconsin Dept. of Revenue to Quiz Tax Filers to Combat Fraud
On January 8, the Wisconsin Department of Revenue (DOR) announced that it is implementing the Identity Verification quiz to prevent fraudsters from stealing the identities and tax refunds of state taxpayers. The DOR hopes the roughly two million dollar cost of the program, which was approved by the Legislature last year, will save the state approximately ten million dollars a year in fraudulent tax refunds and credits. Before receiving the increase in funding for tax fraud prevention, the department conducted reviews of about 15,000 individual income tax returns based on rules used to identify fraud. The DOR also reviewed 15 percent of homestead tax credit claims and five percent of earned income tax credit claims each year, based on rules to identify errors and fraud.
The DOR will identify the risk of fraud based on analytic information. The department will send letters to individuals whose Social Security numbers the agency thinks might be stolen and whose returns might be compromised. The letter will be sent sometime after they file their taxes and will describe how they will have to answer four multiple choice questions either online or over the phone. If the taxpayer fails the quiz twice, he or she will be asked to submit documents to verify their identity. The specific rules for flagging returns are confidential, but the Legislative Fiscal Bureau indicated that more returns of first-time filers are suspended for review than others. Officials estimate that no more than 2% of Wisconsin tax filers will receive the verification letter.
“We know that identity theft and refund fraud are two of the top cybercrimes,” said DOR Secretary Richard Chandler. He also said that Georgia and Louisiana have implemented an identity quiz process similar to what Wisconsin is doing this year and have had success in reducing fraudulent tax activity. The DOR also has hired ten new auditors and three technology support positions to prevent and reduce fraudulent refund and tax credit claims under the individual income tax, the earned income tax, and the homestead tax credit.
The department said most fraudulent claims are filed electronically, often with automatic deposit of refunds. According to DOR officials, tax fraud usually consists of stealing a person’s identity to file a false return, using social security numbers of dead or imprisoned people to file fraudulent returns and credit claims, and creating false wage statements and income tax returns.
Reprinted with permission of the Wisconsin Department of Agriculture, Trade and Consumer Protection
January 17, 2014
DATCP Consumer Alert: Email-Based Utility Scams Aggressively Targeting
Wisconsin Consumers
MADISON – The Wisconsin Department of Agriculture, Trade and Consumer Protection (DATCP) has received a number of complaints and inquiries in January about two different utility scams targeting Wisconsin consumers by email.
The emails in these nationwide scams fraudulently claim to come from one of two legitimate energy providers: Texas-based Atmos Energy or California-based Pacific Gas & Electric Company (PG&E). Both emails tell consumers that they have a past due utility bill. The emails reference fake account numbers and direct consumers to visit linked websites to view their statements or to make a payment. By clicking on any links in the messages, consumers risk having their systems infected with malware and losing personal or banking information to the scammers.
Both Atmos Energy and PG&E have warnings about these scams on their websites. Neither company provides services to Wisconsin consumers.
If you receive an email regarding a past due utility bill from either Atmos Energy or PG&E:
Delete the email immediately.
Do not click any links contained in the message.
Do not download any attachments from the email.
Do not provide any personal or banking information or reply to the message.
If you received the fraudulent PG&E email, you can report the contact to PG&E at [email protected].
For more information or to file a consumer complaint with DATCP, visit datcp.wisconsin.gov, send an e-mail to [email protected] or call the hotline toll-free at 1-800-422-7128.
Florida Judge Halts Suspected Medical Alert Device Scam
On January 13, a federal judge in Florida temporarily halted the operations of scammers suspected of tricking seniors into signing up for medical alert devices. The Federal Trade Commission (FTC) and the Office of the Florida Attorney General had asked the judge to halt and freeze the assets of the Orlando-based operation that used robocalls to pitch “free” medical alert devices to seniors by claiming a friend or family member had signed them up for a prepaid device. The two agencies are seeking a court order to permanently ban the defendants from operating and to require them to pay back consumers who purchased the devices.
The callers claimed the medical alert devices were endorsed by various health organizations, including the American Heart Association, the American Diabetes Association, and the National Institute on Aging, and implied that individuals would not be charged until the device was installed and activated.
The operators actually started charging a $34.99 monthly subscription rate for monitoring of the devices immediately — whether the device had been activated or not.
Approximately 66,000 consumers nationwide filed complaints against the scammers, including 265 Wisconsin residents. The Wisconsin Department of Agriculture, Trade and Consumer Protection (DATCP) issued a scam alert in May 2013 after consumers in the 608 area code, the Green Bay area, Appleton, and the Fox Valley were targeted. Some of the company names listed in the DATCP complaints were: Senior Emergency Association, Senior Emergency Care, Senior Emergency Care Program, Senior 1st Medical Alert System, and Senior Medical Advisory.
The Better Business Bureau of Wisconsin (BBB) also issued a scam alert last spring. “Inquiries from all over the state tell the BBB that phone calls are purportedly coming from phone number (920) 636-4415,” the BBB alert said. “The caller states, ‘I’m calling to confirm your order’ and ‘I’m attempting to install an alarm’ or ‘This is a state of emergency. Seniors have been falling down in their homes.’” The company behind the calls allegedly has received more than $13 million in commissions since March 2012 for marketing the medical alert devices, which officials said were monitored by a different company called Lifewatch USA. No charges have been filed against LifeWatch.
Authorities stress that people who receive robocalls should not press any buttons to be removed from mailing lists or be transferred to a live person. This only confirms to scammers that they have a working number. Officials advise people to just hang up and to file a complaint with the government. Wisconsin consumers can file a complaint with the Wisconsin Department of Agriculture, Trade and Consumer Protection by visiting the agency's website, by emailing [email protected], or calling (800) 422-7128. Consumers can also file a complaint with the FTC by calling (866) 966-7226. Source: Milwaukee Journal Sentinel (January 13, 2014)
Dozens of Retired NYC Workers Accused of Faking Disabilities
On January 7, scores of retired New York City police officers, firefighters, and prison guards were charged with faking psychiatric problems to get federal disability payments, with some falsely claiming their conditions arose after the September 11, 2001, attacks, according to prosecutors. The 205-count indictment alleges that many of the defendants collected between $30,000 and $50,000 a year, based on fabricated claims that they were completely disabled by serious psychiatric disorders. The indictment charges 106 people, four of whom are accused of running the scheme since 1988. Among those arrested were 72 retired city police officers, eight former firefighters, five former corrections officers, and one retired Nassau County Police Department officer. The four accused of being the ringleaders of the scam include retired officer Joseph Esposito, who recruited many of the other defendants; detectives’ union disability consultant John Minerva; lawyer and former FBI agent and suburban prosecutor Raymond Lavallee; and benefits consultant Thomas Hale. The leaders of the scheme coached the former public employees on how to falsely describe symptoms of depression and other mental health problems that allowed them to get payouts as high as $500,000.00, according to Manhattan District Attorney Cyrus R. Vance Jr. He also said that the ringleaders made tens of
thousands of dollars in secret kickbacks. The four of them were charged with first- and second-degree grand larceny and attempted second-degree grand larceny.
The other 102 people charged in the case received Social Security Disability Insurance payments allegedly based on false claims. They were charged with second-degree grand larceny and second- degree attempted grand larceny. A large number of the workers had legitimate physical disabilities that would have entitled them to state disability pensions. However, their disabilities were not severe enough to qualify them for Social Security Disability payments, which require a complete inability to work.
According to Internal Affairs Chief Charles Campisi, many of the officers exaggerated their
psychological trauma to gain the Social Security benefits. Most claimed post-traumatic stress disorder, and many said that it was caused by the September 11 attacks. Campisi said that the New York Police Department has no information that the officers were not actually working after September 11, 2001, just that they overstated the effects of the attacks.
Source: Milwaukee Journal Sentinel (January 8, 2014)
Reprinted with permission of the Centers for Medicare and Medicaid Services January 6, 2014
National Health Spending Growth Remains Low for 4
thConsecutive Year
WASHINGTON — Overall national health expenditures grew at an annual rate of 3.7 percent in 2012, marking the fourth consecutive year of low growth, the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary reported today. Health spending as a share of gross domestic product fell slightly from 17.3 percent in 2011 to 17.2 percent in 2012.
“For the second straight year, we have seen overall health care costs grow slower than the economy as a whole. This is good news,” said CMS Administrator Marilyn Tavenner. “We will continue to work with tools given to us by the Affordable Care Act that will both help us control costs for taxpayers and consumers while increasing the quality of care.”
An article summarizing the study is being published in the January issue of the journal Health Affairs. The entire report is being published on the CMS National Health Expenditures website.
The report found that the continued low growth in 2012 was driven by slower growth in prescription drug, nursing home, private health insurance, and Medicare expenditures. The report from CMS’ Office of the Actuary also found that the Affordable Care Act (ACA) contributed to the slow growth for the Medicare program in 2012, but had a limited impact on overall spending as reforms were still being implemented in 2012.
The report’s findings include:
Private health insurance spending growth remained low. Private health insurance spending
continued to grow at a low rate, increasing 3.2 percent in 2012 compared to 3.4 percent growth in 2011.
Medicare spending growth continued to be low. Despite a large uptick in Medicare enrollment,
Medicare spending growth slowed slightly in 2012, increasing by 4.8 percent compared to 5.0 percent growth in 2011. Total Medicare spending per enrollee grew by only 0.7 percent in 2012.
Prescription drug spending growth was low. Retail prescription drug spending slowed in 2012,
growing only 0.4 percent as the result of numerous drugs losing their patent protection, leading to increased sales of lower-cost generics.
Nursing home spending growth slowed. Spending for freestanding nursing care facilities and
continuing care retirement communities increased by only 1.6 percent in 2012, down from 4.3 percent growth in 2011, due to a one-time Medicare rate adjustment for skilled nursing facilities.
Medicaid spending continued to grow at a historically low rate. Total Medicaid spending grew 3.3
percent in 2012. While an increase over 2011, this increase still represents historically low overall growth rates tied to improved economic conditions, as well as efforts by states to control costs.
The report also found accelerated growth in hospital and physician and clinical services spending, and slightly faster growth in out-of-pocket spending, 3.8 percent in 2012 compared to 3.5 percent in 2011. The full report can be found at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html
Read an article about the report from the CMS Office of Actuary at http://content.healthaffairs.org/content/33/1/67.abstract.
New CMS Regulations Target Medicare Fraud
On January 6, the Centers for Medicare and Medicaid Services (CMS) issued draft regulations that would overhaul the Medicare Advantage and Part D prescription drug programs. Obama
administration officials said the new rule is designed to tackle fraud and would save an estimated $1.3 billion over five years beginning in 2015, when the changes would take effect. CMS believes that the sweeping proposed regulations would strengthen consumer protections, while both cutting costs and improving care for enrollees in the two programs.
If finalized, the regulations would bring physicians under greater federal oversight by demanding that any doctors or “non-physician practitioners” who write prescriptions under the Part D program must be enrolled in Medicare. The move to rein in doctors follows several published reports finding fraudulent and abusive prescribing practices. The proposed rule would also require greater cost savings for beneficiaries, Obama administration officials said, and would enact a provision of the Affordable Care Act requiring that sponsors of Medicare Advantage Part D plans report and return overpayments. The regulations, totaling 678 pages, were published in the January 10, 2014, edition of the Federal Register, starting the clock on a 60-day public comment period that will end on March 7.
Save the Date for the 2014 Dane County/State Triad Conference
The 2014 Dane County/State Triad Crime Prevention and Safety Conference & Expo will be held on September 19 at the American Family Insurance headquarters in Madison. There will be workshops on a variety of crime prevention and safety topics, such as the following: emergency preparedness; introduction to social media; firearm concealment and carry laws; mental health awareness; personal safety; financial exploitation; mail fraud; bullying; and scams and frauds. Seniors, law enforcement, city/county officials, human service professionals, and the general public are invited to attend. For more information, contact Mary Stamstad at [email protected] or 608-441-7897.
SMP Activities
Date Activity County
January 7 SMP Presentation-St. Nazianz Nutrition Site Manitowoc
January 15 SMP Presentation-Cleveland Nutrition Site Manitowoc
January 20 SMP Presentation-Manitou Manor Nutrition Site Manitowoc January 22 SMP Presentation-Sheboygan Falls Nutrition Site Sheboygan January 23 SMP Presentation-Martin Luther King Nutrition Site Racine January 29 SMP Presentation-ADRC/SSA Staff Meeting-Lancaster Grant
January 30 SMP Presentation-Plymouth Nutrition Site Sheboygan
February 1 SMP Booth-Community Health Expo-Superior Douglas
February 4 SMP Presentation-Lincoln Manor-Racine Racine
February 5 SMP Presentation-Trinity Terrace Apts.-Racine Racine
February 10 SMP Presentation-Pinedale Apts.-Onalaska La Crosse
February 11 SMP Presentation-Capitol Lakes-Madison Dane
February 12 SMP Presentation-Heritage Haven-La Crosse La Crosse
February 12 SMP Presentation-Valders Nutrition Site Manitowoc
February 13 SMP Presentation-Glendale Women’s Club Milwaukee
February 14 SMP Presentation-Our Savior’s Lutheran Church-La Crosse La Crosse February 18 SMP Booth-Nursingmatters Expo 2014-Middleton Dane
February 20 SMP Presentation-Halvorsen Apts.-Westby Vernon
February 25 SMP Presentation-Howard’s Grove Nutrition Site Sheboygan
February 26 SMP Presentation-Atonement Nutrition Site Racine
February 28 SMP Presentation-Racine County ADRC Racine
March 5 SMP Presentation-Lincoln Villas-Racine Racine
March 11 SMP Booth- Women’s Health Policy Summit-Milwaukee Milwaukee March 13 SMP Booth-Solving the Dementia Puzzle Conf.-Evansville Rock March 18 SMP Booth-UWEC Senior Americans’ Day-Eau Claire Eau Claire
March 20 SMP Presentation-Burlington Senior Center Racine
March 22 SMP Booth-Wellness & Energy Fair-Waunakee Dane
March 28 SMP Presentation-Racine County ADRC Racine
We are always looking for opportunities to support our colleagues in the aging network. Please contact Wisconsin SMP and let us know about upcoming events in your area.
ATTENTION: All of You with Email…
In an effort to save paper, postage and be “volunteer friendly,” we will email issues of theFraud Alert! to those who have email. Please contact Kevin Brown at [email protected]
and give him your email address to add to our list. Thank you!
For more information, contact:
Elizabeth Conrad, SMP Project Director
Coalition of Wisconsin Aging Groups Elder Law Center 2850 Dairy Drive – Suite 100
Madison, WI 53718-6742
Phone: 800/488-2596 608/224-0606 Email: [email protected]
You can also access our publication by visiting our web site www.wisconsinsmp.org Or you can visit the Coalition of Wisconsin Aging Groups web site www.cwag.org Click on Publications then click on Wisconsin Senior Medicare Patrol (SMP)
and scroll down and click on the edition you wish to view.
Wisconsin SMP
Coalition of WI Aging Groups 2850 Dairy Drive Ste. 100 Madison WI 53718
