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Why COVID-19 Caused Spikes in Health Care Fraud and How to Protect Your Organization

September 21, 2020 Posted by Industry Expert Health IT

By Devin Partida, Editor-in-Chief, ReHack.com
Twitter: @rehackmagazine

As the COVID-19 pandemic posed an increasing health threat worldwide, many fraudsters saw opportunities to trick unsuspecting victims. Here are three kinds of fraud that spiked during the novel coronavirus, and how people in the medical sector can alert and protect their patients.

Treatment Fraud
The COVID-19 pandemic is a scary situation for many reasons, and one of them is that there is no cure for the novel coronavirus. Health care professionals have identified several drugs and interventions that could help patients who contract the virus, but none are available over-the-counter.

That reality has not stopped scammers from offering a slew of products promising to cure the virus. These efforts often span international borders, too.

In one case, a United Kingdom national deliberately mislabeled parcels of merchandise sold as “Trinity COVID-19 SARS Antipathogenic Treatment” kits. The man previously sold them under the name “Trinity Mind, Body & Soul,” but rebranded them as people got more interested in the coronavirus pandemic. He allegedly sold hundreds of kits at $50 each. The instructions for using them included saying a prayer.

This kind of health care fraud gains momentum due to fear and desperation. As people hear about the rising fatalities associated with the virus, they want to do everything possible to stay protected.

Medical professionals should continue to remind their patients that there is no treatment they can buy through the internet or elsewhere. Relatedly, they can remind them of things to do to avoid contracting the virus, such as washing their hands, wearing a mask and practicing social distancing.

Testing Fraud
Particularly in the earlier stages of the pandemic, news broke about slow testing times and some Americans having difficulty getting approved to have tests performed. Many scammers capitalized on those challenges and positioned themselves as independently able to offer COVID-19 tests — often through a door-to-door or telephone-based system.

On March 22, 2020, the U.S. Department of Justice filed the first enforcement action against COVID-19 fraudsters. That was for a wire fraud scam associated with COVID-19 products sent through the mail. However, scam artists rapidly adopted different methods, specifically to target Medicare beneficiaries. They used a variety of channels to connect with victims, including social media.

These tactics pose health care security risks because criminals try to get the details needed to bill for services provided through Medicare. Such attempts constitute medical identity fraud. If Medicare denies the claim, the beneficiary bears responsibility for the costs.

Medical organizations and the people who work for them can fight this kind of fraud through accurate information. They should remind people never to provide personal details to anyone, even if that party claims to offer a free or quick test. Publishing information about the steps a person should take if they feel they need a coronavirus test is useful too.

Relief Fraud
One of the bright spots in the unsettled times associated with COVID-19 is that many people are exceptionally willing to donate money to worthy causes. They know the burdens the coronavirus can cause and want to do whatever they can to alleviate them — even in small ways. Unfortunately, scammers sought to exploit this generosity, often by posing as legitimate organizations.

The World Health Organization warned people of schemes associated with payment requests for a relief fund. The WHO has one, but it does not contact people to ask for credit card or banking details and get donations. If people want to donate, the safest way is to go directly to an organization’s legitimate website and provide details there.

Instances of relief fraud also cropped up in association with government relief programs for small businesses. This kind of fraud spanned beyond health care but also included it. In one case, a Seattle physician allegedly tried to claim $3 million in assistance by misrepresenting businesses or wholly fabricating them to qualify for the aid.

Staying safe from relief fraud starts with practicing smart health care security. Many fake requests for aid begin as phishing emails. People are so eager to do what they can to assist during this unprecedented situation, and they might bypass checks otherwise performed to verify a sender’s authenticity.

Concerning people wrongfully qualifying for aid, organizations can cut down on this kind of fraud by restricting and monitoring access to the information a person needs to submit the necessary paperwork. It only takes one individual acting unlawfully to tarnish the reputation of an otherwise upstanding organization.

Curbing the New Opportunities
Scammers always look for new ways to exploit their victims. The COVID-19 pandemic offered plenty of them by sparking elevated fear, unease, desperation and willingness to help. Reminding people to stay vigilant and never assume all is well will help cut down on successful fraud attempts.

Tags: COVID-19Devin Partidahealthcare fraud

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