Criminals turn to giveaway scams to lure insured patients

Kickbacks aren't the only way to draw people into fraud schemes: From overstuffed chests to overstuffed seating, criminals use gifts and incentives to reel in a steady stream of insured customers.  

In a scam involving a California surgical center, for example, prospective patients learned that if they underwent endoscopies, colonoscopies or cystoscopies, they could later get low-cost cosmetic surgery and liposuction, CBS News reported. The scheme resulted in more than $50 million in inappropriate claims, an indictment alleges.

Other criminals offered patients free plane tickets to travel thousands of miles for outpatient surgery available locally. Patients received free hotel accommodations, tickets to Disneyland and even breast implants, as FierceHealthPayer reported in an exclusive eBook, "Payers Embrace Big Data."

Medical alert scams targeting senior citizens are also common, according to the Pittsburgh Post-Gazette. Thieves convince victims to disclose their Social Security numbers and other protected health information in exchange for devices that call for emergency help.

Free furniture can be a big draw: A California medical equipment supplier lured Medicare beneficiaries into clinics with the promise of a reclining sofa. This was part of bait-and-switch scheme where patients received power wheelchairs they didn't want or need.  

And who can resist a free big-screen TV? Federal agents have raided patients' homes and found identical television sets distributed as part of a scam, Aetna special invesitgations director Ralph Carpenter told USA Today.

Spa-type services have also brought patients through the doors. Criminals have arranged massages, pedicures and sessions with personal trainers and later billed these as covered healthcare benefits, USA Today noted.

Finally, two former hospital executives in Atlanta face criminal charges for allegedly participating in a scam that recruited pregnant, illegal immigrants to give birth in U.S. hospitals. Newborns became American citizens with Medicaid picking up the tab for their deliveries. Estimated losses from this scheme exceed one million dollars, WSB TV added.   

For more:
- here's the CBS News article
- see the Pittsburgh Post-Gazette article
- read the USA Today article
- view the WSB TV piece

>> Download the free FierceHealthPayer eBook, "Payers Embrace Big Data."

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