Medicare Secret Shoppers

VolAgent · 10-31-2009, 09:31 AM

Originally Posted by ronmelton3

Can you say entrapment!

Entrapment is when a law enforcement official induces or encourages you to commit an illegal act that you would not otherwise do. Someone lying to you about who they work for is hardly entrapment. If its illegal, its always illegal, not only when its done in front of a CMS employee or contractor.

The point of the memo is because you are probably violating a regulation to ask. Also, just imagine what the senior must think when you ask if he or she is a CMS employee?

Fishtoe · 10-31-2009, 04:45 PM

Thanks for this repoar. Very helpful.
Fishtoe

SeniorInsuranceGuy · 11-04-2009, 06:39 PM

I refuse to do meetings anymore for the mere fact that I could be secret shopped by someone who I have forgotten more about this stuff than they know, yet get in to trouble as they report back to CMS. Dont need the headache and I do realize I'm losing money for not doing it but oh well, I like no-stress. An earlier post made a great point about putting emphasis on the scammers of DME billing to Medicare. Anyone see the 60 minutes piece two weeks ago? Stunning as to incompetent Medicare is.

sodaytongal · 11-13-2009, 07:38 PM

They are out there for sure! Interestingly enough my neighbor (who has nothing to do with insurance) got called to secret shop at a public event posing as someone interested in MA plans.

captain94 · 11-13-2009, 08:42 PM

Originally Posted by sodaytongal

They are out there for sure! Interestingly enough my neighbor (who has nothing to do with insurance) got called to secret shop at a public event posing as someone interested in MA plans.

Is he over 65 or younger?

sodaytongal · 11-14-2009, 06:28 AM

I'm not sure she accepted the assignment . . . the preferred requirement was that you be at least 55 years of age and be realistically able to pass as being 65 or a less preferred requirement being 25 years of age plus. My friend is in her early 40s.