Medicare Fraud Prevention Week Puts Focus on Protecting Seniors from Scams – Herb Weiss

By Herb Weiss, contributing writer, aging isues  

As skyrocketing Medicare fraud schemes cost taxpayers billions each year, congressional leaders, federal agencies, and consumer advocacy groups intensify their efforts to combat aggressive scams targeting older Americans.

Experts estimate that Medicare fraud, waste, and abuse may cost as much as $60 billion annually. However, no federal agency publishes a definitive total amount because much of the activity goes undetected.

The growing incidents of Medicare fraud, waste, and abuse framed the discussion on June 3, 2026, at the Leon Mathieu Senior Center in Pawtucket, where more than 40 older adults gathered for the Fifth Annual Medicare Fraud Prevention Week event.

During the 75-minute presentation, three federal officials shared valuable information with the attending Medicare beneficiaries, designed to increase their awareness of fraud tactics and equip them with practical strategies to safeguard their personal and health care benefits.

The afternoon program was hosted by Rhode Island’s Senior Medicare Patrol (SMP), along with special agents from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), the Centers for Medicare and Medicaid Services (CMS), and the City of Pawtucket.

At the gathering, municipal, state, and federal leaders warned that Medicare recipients remain primary targets of fraudsters who use fake medical claims and identity theft. Specific types of fraud were highlighted, including durable medical equipment (orthotic braces, urinary catheters), genetic testing, and fraudulent billing by medical providers.

Learning to Spot the Warning Signs

Christine Anderson, Health Information Manager at the Rhode Island Office of Healthy Aging (OHA) and the leader of the state’s SMP program, said the program’s goal is to provide beneficiaries with practical tools to protect themselves and encourage them to be more proactive in reporting suspicious fraud activity, potentially reducing the success rate of scams within Rhode Island.

Anderson emphasized that scammers will often pose as representatives of Medicare, Social Security, or local human services offices to obtain or confirm Medicare numbers, which can be used to bill for unnecessary durable medical equipment such as back or knee braces.

SMP’s Program Manager urged attendees to review their Medicare Summary Notices (for Original Medicare) or their Explanation of Medical Benefits (EOMB), and to seek assistance from the SMP program and the Leon Mathieu Senior Center (or their local senior center) if they see unfamiliar charges.

“If something doesn’t look right, ask questions,” Anderson urged.

“We are grateful to the OHA, HHS-OIG, CMS, and the SMP for bringing this important information directly to our residents,” Donald R. Grebien, Mayor of Pawtucket said. “Education and awareness are critical in protecting older adults and preserving the integrity of the Medicare system.” It is one of the strongest defenses against scams targeting older residents,’ he says. Grebien pointed out that fraud can threaten both the financial security and well-being of seniors.

Echoing Grebien’s sentiment, Elizabeth Moreira, Pawtucket’s Deputy Director of Administration, said community education is key, stressing that awareness of the growing prevalence of scams is one of our strongest tools for preventing fraud. “Events like today give our community and caregivers the tools they need to recognize warning signs, protect their personal information, and report fraud before it can harm them,” Moreira said.

Federal Enforcement Efforts

HHS-OIG Special Agent Victoria Mens and Assistant Special Agent Lindsay Walford described their federal agency’s role in investigating fraud, waste, and abuse across more than 100 HHS programs, including health, social, and Medicare and Medicaid programs.

The federal agents also explained how they fight Medicare fraud, waste, and abuse.

They highlighted how the Office of Audit Services and the Office of Evaluation and Inspections publish reports on systemic problems including nursing homes lacking emergency power and using antipsychotic drugs to control residents.

To safeguard $2 trillion in federal healthcare funds, HHS-OIG conducts audits, evaluations, and criminal investigations.

The federal officials also cited prosecutions involving overbilling for medical equipment, large-scale catheter fraud schemes, and psychiatric billing for services that were never provided.

One of the most costly schemes involving urinary catheters was estimated to have resulted in attempted losses of about $4.5 billion, notes Walford.

During the presentation, Walford cited a Rhode Island case. She noted that Zynex Medical allegedly overbilled multiple payers about $873 million for TENS units and excessive supplies, leading to criminal charges against company leaders and a non-prosecution agreement with the company.

“A lot of that has been stopped, and so that money hasn’t all gone out, but that’s the tune and counting as to how much they’re attempting to pull out of the Medicare Trust Fund,” Walford said. She gave an overview of HHS-OIG accomplishments.  Between April and September 2025, OIG work led to $2.2 billion in recoveries through settlements and criminal restitution. The agency said it returns nearly $13 for every dollar spent on oversight.

During the same period, investigators completed more than 900 investigations and issued hundreds of recommendations to prevent improper payments, says Walford.

Protecting Yourself

Mens urged seniors to treat their Medicare number with the same care as a Social Security number. “Don’t give out that information,” she warns. “If someone calls claiming to be from Medicare or says they are your healthcare provider, hang up and call back using a number you know is legitimate,” she says.

“Scammers rely on urgency,” Mens said. “Take time to talk with a family member, Medicare representative, or healthcare professional before making any decisions,” she says.

Jennifer Syria, Regional Administrator for the Centers for Medicare & Medicaid Services, pointed out that beneficiaries play a critical role in preventing fraud. “When you review your statements and notice unfamiliar charges, you become a valuable investigator in preventing fraud,” Syria said.

Syria encouraged residents to report suspected fraud and have key details ready, including provider names, dates of service, payment amounts, and Medicare Summary Notices.

For more details about Rhode Island’s Senior Medicare Patrol program, call (401) 462-0530.  Or email, [email protected].

To read more articles by Herb Weiss, go to:  https://2×8.ea2.myftpupload.com/herb-weiss/

Herb Weiss, LRI, 12, is a Pawtucket-based writer who has covered aging, healthcare, and medical issues for more than 45 years. To purchase his books, Taking Charge: Collected Stories on Aging Boldly and its two sequels, visit herbweiss.com.