Beware of Phantom Pharmacies

Why am I not surprised to find out that federal health officials have failed in their efforts to police the emergence of phantom pharmacies?

These pharmacies are fly-by-night storefront operations that bilk millions of dollars in false Medicare bills and then vanish with the cash.

No permits are needed — there is no store or pharmacy as we know them. There are no medicines on the shelves, no employees, no real in-store customers, and yet these fake pharmacies produce huge bills for medication, defrauding Medicare of millions of dollars a year.

It seems the only people making money these days are the crooks.

How is this accomplished? Thieves, crooks and fraudsters use a legitimate address to establish a fake pharmacy business. Then, using stolen ID and patient insurance ID numbers (mostly from seniors), scammers write fraudulent prescriptions for expensive drugs that were never actually prescribed.

Next, they submit these fake prescriptions for reimbursement to insurers, Medicare or Medicaid. In a single claim, a fake pharmacy canmake anywhere from $2,000 to $8,000. Some “fraudster pharmacies” only exist a few days! By the time the fake reimbursements have been collected, the phantom pharmacies have long since closed and their operators have disappeared without a trace.

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Several Bills Currently In Congress

There are several bills currently in Congress that will impact Medicare and senior service providers:

The first is a reintro­duced initiative to forgive student loans for those medical professionals who agree to service seniors in underserved ar­eas.

The second is a bill which would modify the new rule requiring a face to face doctor visit for ordering Medicare home health nursing services, by expanding the rule to allow nurse practitioners to order the visits as well.

Third, patients, families, and facilities are negatively impacted by the arcane rule requiring a three day stay in the hospital in order for Medicare to pay for the skilled nursing facility charges. There is a bill before Congress that would change this requirement to include “observation” time.

Thanks to Robin Smith Consulting for these valuable updates

Plan For The Worse…Live For The Best

Here is what I know – At 59 I’m healthier than either of my parents were at age 59. I have never smoked. I’m fairly active and exercise some but not overly. I eat fairly well, but not always. I drink socially but not in excess. So what are my odds of remaining healthy and being able to care for myself? Better, I’m sure than my parents but the fact remains that the odds of something happening to me beyond my control still exists. Any number of accidents could befall me. What then?

We Boomers don’t like to think or talk much about aging. For us, and many in our generation, the idea of needing long term care is down the road a ways.

We avoid discussing these issues for several reasons; most notably as discussed above is that of denial. Secondly, I think that we have come to expect that the government will take care of us through Social Security, Medicaid and Medicare. Unfortunately, we ignore the fact that these programs are not fail safe measures of obtaining care especially if we want to remain in our homes. Yes, it is likely some form of government benefits will be there but statistics and finances will make it more difficult for us to receive these benefits.

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Home Instead Senior Care Is On Cable!

Finally, we are ON AIR! Just wanted to let our BLOG, TWITTER and FACEBOOK friends and readers know that the Home Instead Senior Care cable show is on! Hope you enjoy watching and hearing from those business’ and people who offer additional support and help to the growing population of seniors. It is my hope that the cable show will offer insight into better managing our families as we all enter into the ‘golden years.’ Here’s the cable station internet, AACS link where you may view the shows that have previously aired. Each week additional shows will be added. Lots more to come…guests are already booked through August. Any ideas for what you may want to know more about, your comments and/or input is always appreciated!

What, The Boomers Are Retiring?

Every now and again when I find another BLOG or column that is relevant or has what I call ‘stuff to think about’ I like to post a copy here. Recently I had an opportunity to speak with Steve Davis, a Certified Financial Planner from Mansfield and he offered up several of his articles. I felt this one was apropos!

The last time I visited my parents in Florida, we were missing one ingredient needed for that night’s dinner. I offered to take a “quick” run to the store to pick it up. Well, if you’ve ever gone grocery shopping there, you’ll know that there is no such thing as a quick run to the store. You see, the people there don’t work anymore and have all the time in the world — I got back just in time for dessert. Okay, I may be exaggerating but you get the point; there are a lot of retirees in Southern Florida. Believe it or not, it won’t be long before the whole country has the same proportion of “seniors” as Florida does today. Can you believe that the first of the baby boomer generation turned 65 years old on January 1 of this year? It’s true. And for the next 19 years, ten thousand boomers a day will reach that milestone. I was born in 1963 and that means that I’m among the last of the Baby Boomers. By the time I reach retirement age it is estimated that nearly 20 percent of the US population will be age 65 or older.

For the remainder of this article (and important subject, click here…)