 
To: AAPS
MEMBERS
We are passing along this
important fraud alert issued by the Florida Medicare Provider website
http://www.floridamedicare.com/provider/html/mainPage.asp .
December 28, 2004
Provider Enrollment Fraud
Alert
This is to inform you that Medicare is
aware of an organized group who is representing themselves as
either a Medicare fraud investigator; or
a Medicare employee from the enrollment, claim or audit units.
These callers tell the physician, or
office personnel, that the Medicare computer system has had a
malfunction and they need to update lost
information. The callers may also say they need to update the
physician’s provider record. They then
request via telephone or fax the following information:
• Copy of
physician’s drivers license
• Copy of
physician’s social security number (SSN)
• Unique
physician identification number (UPIN)
• Verification of education
• Verification of practice location
• Copy of
physician’s medical license
• Copy of
patient’s charts for a specific period of time.
Once the entity receives this
information, they falsify enrollment data using the physician’s name
and
request a change to their practice
locations, telephone numbers, and pay-to-addresses.
The Centers for Medicare & Medicaid
Services (CMS) has not suffered any computer system
malfunction and are not calling
providers requesting the above information be provided. If you
should receive such a call, please try
to verify the telephone number of the caller, and immediately
notify
your Medicare carrier that you suspect
fraud.
CMS is committed to protect all Medicare
providers/suppliers and to ensure that only those qualified
make changes to enrollment data. CMS
believes that with your help we can target those unscrupulous
individuals that are looking to take
advantage of you and the Medicare trust fund.
To report these calls please contact the
toll-free number for First Coast Service Options, Inc.
Medicare Part B Customer Service Center
at 1-866-454-9007.
Source: CMS JSM-05154, December 27,
2004 |