health care fraud Archives

UnitedHealthcare today issued a scam alert in response to reports of a number of calls attempting to solicit personal information from railroad workers.
An email from Gail Snopkowski, senior service account manager of railroad accounts for UnitedHealthcare, to SMART TD said “several” railroad members have received unsolicited phone calls claiming to be from the insurer.
“Be assured that UnitedHealthcare is not involved in any such activity, and the phone number being used by the caller has been identified as a SCAM,” Snopkowski said in the email.
The alert from UnitedHealthcare identifies fake calls from 678-384-4965 as coming from a Georgia area code and telling members to call 888-315-7524 and ask for “UnitedHealthcare options.” Fake calls also were reported to UnitedHealthcare as coming from a Tennessee area code.
“UnitedHealthcare does not place calls to members asking them for their Social Security number. Do not provide any information to these callers,” the alert said.
The alert also provided tips to avoid this and similar scams:

If you receive an unexpected call or text from any area code/phone number you don’t recognize, never answer it. If it’s someone with a legitimate inquiry, they will call back or leave a message.
If you do answer it and you believe the call is suspicious, call the Member Services number on the back of your medical ID card to speak with a customer service representative.
Always be sure to review your phone bill carefully and contact your carrier about any suspicious charges.
If you or someone you know becomes a victim of a phone scam, you can file a complaint online with the Federal Trade Commission and the Federal Communications Commission under the “For Consumers” tab.

In the wake of 10 more arrests of Long Island Rail Road retirees for alleged conspiracy to commit health care fraud in collecting disability payments, the U.S. attorney in charge of the investigation has offered amnesty from prosecution for any retiree who comes forward voluntarily and admits having made false or misleading statements when applying for those disability benefits.

Applications for amnesty will be mailed by the Justice Department to all Long Island Rail Road retirees receiving Railroad Retirement disability payments, according to federal prosecutors. The amnesty program will include two deadlines — July 6 and Aug. 10 — as will be explained in the applications being mailed.

In October 2011, 11 initial arrests were made – seven Long Island Rail Road retirees, two physicians, an office manager for one of the physicians and two described as “facilitators” alleged to have acted as liaisons between the retirees and the physicians. Federal prosecutors allege the physicians fabricated or exaggerated medical assessments used by the retirees to claim disability benefits.

All of those charged have pleaded not guilty. Trials are scheduled to begin in February 2013.

U.S. Attorney Preet Bharara previously said some 1,500 now retired Long Island Rail Road workers are under investigation for conspiracy to commit health care fraud.

Retirees so far arrested allegedly filed disability claims following their retirements – claims alleged by prosecutors to be false. A New York Times investigation, followed by a federal probe, alleged many retirees who had filed disability claims were seen later engaged in strenuous recreational activities, including golf, tennis and bicycle riding.

Federal Prosecutor Danya Perry said those who do not voluntarily come forward face criminal prosecution as the investigation moves forward.

FBI Assistant Director-in-Charge Janice K. Fedarcyk said: “Last October, when we carried out the first round of arrests in this investigation, we encouraged other fraudulent disability pensioners to come forward. We said then that if we didn’t hear from them, they would likely hear from us. That was not an idle threat then, and it is not now. If you are culpable in this fraud, the voluntary disclosure program announced today is certainly a better choice than crossing your fingers and hoping we don’t find you.”

Those seeking more information may contact the U.S. attorney’s office via email:

usanys.lirrprogram@usdoj.gov

or by leaving a telephone voice message at 212-637-2332.