FBI says insurance fraud assumes many forms
Wallingford, CT – June 11, 2009 – As baby boomers enter their silver years, they are becoming targets of sophisticated medical insurance fraud.

Connecticut Better Bureau President, Paulette Scarpetti, says victims are easy prey for fraudsters.

“Consumer education can help people in need of medical attention protect themselves from these crimes. Medical insurance fraud doesn’t only contribute to skyrocketing insurance premiums, but they can also compromise patients’ health.”

The Federal Bureau of Investigation (FBI) has issued an alert about the top four most common types of health Insurance frauds: Medical Equipment Fraud, “Rolling Lab” Schemes, Services not performed and Medicare fraud.

Medical Equipment Fraud:
Individuals are offered “free products” from equipment manufacturers. Insurers are charged for products that were not needed and/or may not have been delivered.

“Rolling Lab” Schemes:
Unnecessary and sometimes fake tests are administered at health clubs, retirement homes or shopping malls and billed to insurance companies or Medicare.

Services Not Performed:
Customers or health care providers bill insurers for services never rendered by changing bills or submitting fake ones.

Medicare Fraud:
Medicare fraud can take the form of any of the schemes described above, and seniors are frequent targets of Medicare schemes, especially by medical device manufacturers who sell medical equipment and offer seniors free medical products in exchange for their Medicare numbers.

The fraudsters will either forge a physician’s signature or bribe an MD for merchandise or a service, and then bill Medicare for medical devices that were neither needed nor ordered.

Estimates by government and law enforcement agencies place the loss due to health care fraud as high as 10 percent of our nation’s annual health care expenditure—or a staggering $226 billion—each year.

Other types of healthcare fraud target the patients with Medical Identity Theft: using a person’s name or other identifying information without that person’s knowledge or consent, to obtain medical services or goods, or to submit false insurance claims for payment.

Medical identity theft frequently results in erroneous information being added to a person’s medical record, or even the creation of an entirely fictitious medical record in the victim’s name.

Methods used to carry out healthcare fraud include:

•Misrepresenting non-covered treatments as medically necessary covered treatments for purposes of obtaining insurance payments—widely seen in cosmetic-surgery schemes, in which non-covered cosmetic procedures such as “nose jobs” are billed to patients’ insurers as deviated-septum repairs.

•Falsifying a patient’s diagnosis to justify tests, surgeries or other procedures that aren’t medically necessary.

•Billing a patient more than the co-pay amount for services that were prepaid or paid in full by the benefit plan under the terms of a managed care contract.

•Connecticut Better Business Bureau offers the following advice to prevent consumers from becoming targets of healthcare fraud:

•Protect your health insurance ID card like you would a credit card. In the wrong hands, a health insurance card is a license to steal. Don’t give out policy numbers to door-to-door salespeople, telephone solicitors or over the Internet. Be careful about disclosing your insurance information and if you lose your insurance ID card, report it to your insurance company immediately.

•Report fraud. Call your insurance company immediately if you suspect you may be a victim of health insurance fraud. Many insurers now offer the opportunity to report suspected fraud online through their Website.

•Be informed about the health care services you receive, keep good records of your medical care, and closely review all medical bills you receive.

•Never sign blank insurance claim forms.

•Never give blanket authorization to a medical provider to bill for services rendered.

•Ask your medical providers what they will charge and what you will be expected to pay out-of-pocket.

•Do not do business with door-to-door or telephone salespeople who tell you that services of medical equipment are free.

Popular social networking sites being used by hackers, con artists and ID thieves

Wallingford, CT – February 17, 2009 – Perhaps it was just a matter of time: Cyber-criminals have moved to popular social networking sites to spread viruses and steal users’ identities.

Sites like Facebook and MySpace have become fertile ground for hackers and scammers to lure unsuspecting users into downloading computer viruses and divulging personal information.

Connecticut Better Business Bureau President, Paulette Scarpetti, says scammers have found a new platform from which to do damage.

“As of December, Facebook had an estimated 150 million active users of all ages, many of whom are unaware that there are people on the same site trying to corrupt their computers and steal their identities. This is a wakeup call for all users, and especially, parents because of the vulnerability of young people on social network sites.”

The popularity of social networking sites has grown exponentially in recent years as a venue for finding and reconnecting with old friends we know and trust.

Better Business Bureau, however, warns that scammers know they can take advantage of that trust by posing as friends, family members and co-workers in order to commit cyber crime.

Common social networking schemes include:

“Friend in Distress” Scam

Facebook users may receive an e-mail from a friend saying they are in dire trouble – and need money wired to them.

The recipient is unaware their friend’s account has been hacked and that the message was sent by cyber criminals who ask that the friend wire them money. If the Facebook user wires the cash, they then discover their friend is safe, the e-mail was a scam and that there is no way of recovering the money.

Phishing Friends

A particularly aggressive computer virus called “Koobface” made the rounds on MySpace and recently hit users of Facebook. Users receive a message from a friend saying “You look awesome in this video,” and which contains a hyperlink to an outside web site to view the video.

When the victim clicks on the link they are told they have to update the popular Internet browser plug-in Adobe Flash. Agreeing to the download installs the virus onto the victim’s computer and monitors Internet activity to potentially steal personal information. Victims of the Koobface virus have experienced considerable difficulty removing it, and in some cases, simply scrapped their computers.

Your BBB has some advice for staying safe on social networking sites:

Be wary of messages from friends or strangers that direct you to another web site via a hyperlink.

Before wiring money to a “friend in distress,” users should attempt to contact the friend directly to confirm the situation. If that is not possible, BBB recommends asking a question to which only the friend would know the answer.

Keep important information private. While some social network sites allow the user to share phone numbers, birthdates, e-mail and postal addresses, BBB recommends against posting such information to prevent a cyber thief from gathering enough information to steal a user’s identity.

Be selective when accepting friend invitations. BBB warns it is best to decline a request for friendship from someone the user doesn’t know.

More advice on staying safe online is available at www.bbb.org.

Connecticut Better Business Bureau alerts homeowners about common scare tactics used by unscrupulous service providers

Wallingford, CT – November 12, 2008– As Connecticut consumers begin winterizing their homes, a warning from your BBB: watch out for “furnace-fixing” con artists.

While most furnace repair companies are honest, reputable and fair, there are a few that may try to frighten you into repairing or replacing the core of your home heating system, even when it is functioning properly, according to Paulette Hotton Scarpetti, President of Connecticut Better Business Bureau.

“Unscrupulous furnace repair companies may warn you that your furnace is leaking dangerous gases that could explode or harm people in the house. The most important first step—is don’t panic. Ensure your home is safe and then get your furnace inspected by your oil company or a second repair service.”

BBB offers the following tips to ensure you don’t get fleeced by disreputable operators:

•If you are told your furnace must be replaced because it is too small, think back to whether it has ever failed to properly heat your home. If you do buy a furnace, don’t waste money on a furnace that is unnecessarily large for the size of your home.

•Check the warranty on your heating system. Many of them come with long-term warranties

•Always get a second or third opinion as to whether repairs or replacement are needed. All bids should be in writing and provide a full description of services provided and materials used.

•When considering a bid, compare more than cost. Check the size and efficiency rating of the equipment each bidder proposes, and then ask how they arrived at recommending a particular sized system.

If you determine repairs or replacement is necessary, select a contractor with a solid reputation for dependable, reasonably-priced work. Ask friends, neighbors and family members for recommendations, and check out any company you’d like to hire at bbb.org for a Reliability Report.

Do not hesitate to call your public utility if you heat with natural gas, and ask a serviceman to inspect your system. If you believe you are in physical danger, leave your home until your heating system is checked out.