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Medicaid and Medicare Fraud

Medical bills and expenses can be crippling in today’s world, especially for older people who need more frequent check-ups, procedures, or extensive surgeries. Fortunately, there are services available for elderly people who need help paying for their medical bills—Medicaid and Medicare. But these insurance providers are often widely abused by nursing homes and doctors who treat older patients, resulting in one of the most insidious forms of financial elder abuse.

Because there are so many people over the age of 65 living in California, our state’s nursing homes are often full of elders who need extra day-to-day care, or who are too sick to live on their own. And unfortunately, abuse is rampant in many of these institutions, financial elder abuse lawyers in San Francisco report. Medicaid and Medicare fraud schemes are particularly prevalent because many older citizens rely on these government-funded services to handle all their medical needs, which can be extensive and costly.

According to research done by the National Adult Protective Services Association, 1 in 9 senior citizens reported being victims of abuse, neglect, or exploitation in the last year. Additionally, 1 in 20 senior citizens believed themselves to be victims of financial mistreatment. But only 1 in 44 cases of financial abuse are actually brought forward by the victims or their families, and the perpetrators are taken to court. The lack of awareness and action may be due in part to the fact that nearly 90% of all elder abusers are people that the victims are familiar with, and trust with their financial and physical wellbeing. This could be anyone from a close friend to a family member to a member of the hospital or nursing home staff.

How Medicaid / Medicare Scammers Operate

In financial abuse cases involving Medicaid or Medicare, nursing home or a care center for the elderly will request reimbursement from the insurance providers for services that they have not performed or have performed improperly or incompletely. Often, doctors, nurses, and home administrators can steal millions this way, relying on their elderly patients not to follow up or to question the bills to their providers.

In another, similar, scheme scenario, doctors and administrators will overmedicate patients, prescribing antipsychotics and other unnecessary drugs, usually with a calming or sleeping agent, to sedate patients unnecessarily. This is done solely so that staff members do not have to deal with the senior citizens as much, San Francisco financial elder abuse lawyers say.

But this type of financial elder abuse doubly threatens older Californians as victims. Those who are targeted individuals are not receiving proper medical care, even though they are paying for it through their insurance provider. And any other person who relies on government-funded programs like Medicaid and Medicare is being cheated out of funds that they so desperately need to cover medical expenses.

Contact a San Francisco Financial Elder Abuse Attorney Today

If you suspect elder financial abuse of any kind, contact an attorney immediately. At the Evans Law Firm, Inc., our San Francisco financial elder abuse lawyers represent clients who have had their Medicaid or Medicare insurance coverage abused through unnecessary or fraudulent billing. Contact one of the attorneys at the Evans Law Firm to discuss your case today at or 415.441.8669.

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