CMS Issues Fax Scam Warning

June 30, 2009
Michael Sheehan

The Centers for Medicare and Medicaid Services has issued an alert to physicians warning them of a scam that involves fake faxes sent to the doctors’ offices. According to the CMS, the scammers pose as a Medicare carrier or a Medicare Administrative Contractor (MAC) to try to obtain billing information and other sensitive data. The faxes may include a CMS or MAC logo.

The faxes ask office staff to fill out a questionnaire providing account information within 48 hours to prevent a gap in Medicare payments. The CMS alert cautioned doctors to be leery of any such requests and to check with their contractor before providing any information. According to a CMS spokesperson, scammers who obtained billing information from providers could use it to submit fraudulent claims to Medicare and to other third-party payers.

Elsewhere on the anti-fraud front, a beefed-up federal task force obtained indictments against 53 clinic owners, doctors, and patients suspected of fraudulently billing the Medicare program for more than $56 million. The FBI has arrested 40 of the 53 suspects named in the indictments, which allege that the suspects billed Medicare for medical services, such as infusion therapy, that were not necessary or were never performed. The arrests were made in Detroit and in Miami, which has been targeted as an epicenter of Medicare fraud for the past several years. In fact, according to federal officials, many of those indicted in Detroit had imported their scams from Miami to avoid an aggressive crackdown on Medicare fraud in the South Florida area.