Social Engineering: The New York Statewide Senior Action Council's "Medicare Fraud of the Month" for September

Albany, N.Y., September 28, 2023---The New York StateWide Senior Action Council (StateWide), an organization dedicated to advocacy for the rights of seniors in New York State, today announced its Medicare Fraud of the Month for September: Social Engineering, the use of deception to manipulate individuals into divulging confidential or personal information that may be used for fraudulent purposes. Scammers are using Social Engineering tactics, Artificial Intelligence (AI), Chatbots, and Robocalls to commit Medicare Fraud.

The StateWide Fraud of the Month is a component of the Senior Medicare Patrol (SMP), the definitive resource for New York State’s senior citizens and caregivers to detect, prevent, and report healthcare fraud, errors, and abuse. StateWide is New York’s grantee/administrator for this Federal Program.

“Scammers gather information from various resources including data leaks, the internet, and the dark web. They use a hook to lure a potential victim then establish a relationship with them to play the game of exploitation. Then they must quickly leave the conversation before suspicion sets in,” said Maria Alvarez, StateWide’s Executive Director in announcing this month’s Medicare Fraud.

“Fraudsters are using AI, Chatbots, and Robocalls to execute social engineering with the goal of obtaining a persons’ personal health information (PHI) or personal identifying information (PII) to file fraudulent insurance claims, receive medical services, or obtain prescription drugs.

“Scammers will use Robocalls and Chatbots to make unsolicited calls to potential victims and ask general ‘yes’ or ‘no’ questions such as “Do you have Medicare?” or “Is your first name Joseph?” This is an attempt to record a “Yes” that they use to authorize fraudulent products or services to Medicare. These tactics impact an individual’s medical identity and can be very dangerous,” Alvarez added.

StateWide offers the following recommendations for seniors to protect themselves from Social Engineering Fraud:

Beware of Unsolicited Communication— screen phone calls to answer numbers you recognize and utilize voicemail to limit contact with Chatbots and Robocalls.

Review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) regularly for unauthorized claims or services.

Educate Yourself—Stay informed about common healthcare scams.

Report suspicious activity—contact the NYS Senior Medicare Patrol Helpline at 800-333-4374.

It is estimated that Medicare fraud costs taxpayers over $60 billion dollars nationally per year. To help combat this illicit industry StateWide announced its Fraud of the Month program in 2022 to highlight these scams being perpetrated on the State’s seniors.