The U.S. Centers for Medicare & Medicaid Services (CMS) recently elaborated on its plans to expand public education campaigns designed to help protect hospice beneficiaries from fraudulent actors in the space.

Program integrity concerns have heated up in the hospice industry. Swarms of new hospices have emerged in certain regions in recent years, with some unscrupulous operators receiving federal funding through illegitimate business practices.

Fraudulent operators’ marketing strategies have included the use of illegal or unethical tactics, such as enrolling Medicare beneficiaries in hospice care, often without their knowledge or without providing services. Scammers have also offered individuals hundreds of dollars in exchange for their Medicare identification beneficiary number.

CMS’ Centers of Program Integrity has ramped up Medicare beneficiary education efforts designed to help identify fraudsters, according to Thomas Pryor, nurse consultant and program lead of CMS’ Hospice Survey and Certification.

“One of the areas we’re working with right now is to enhance education — beneficiary education specifically,” Pryor said during a recent CMS webinar. “We have hospice beneficiaries who are unfortunately fraudulently signed up for the benefit in these kind of, what we call, ‘door knocker scams.’”

The scams include bad actors reaching out to beneficiaries with offers of free goods and services, such as groceries, TVs, reclining chairs and furniture, Pryor explained. The fraudulent marketing tactics are posing significant complications for Medicare beneficiaries, he said.

“When they get the [Medicare Beneficiary Identification (MBI)] from the beneficiary, ultimately in many of these cases [the beneficiary] finds out that they’ve inadvertently signed up for the hospice benefit and that creates other issues for them regarding their normal Medicare coverage,” Pryor said during the webinar.

Fraudulent marketing activity in part sparked CMS to launch a bilingual outreach toolkit for hospices, which the agency disseminated to providers and stakeholders in late July 2023. The toolkit includes guidelines for hospices to help educate Medicare beneficiaries and their families on ways to protect themselves against fraudulent marketing practices.

Scammers have offered seniors incentives such as “in-home perks” including free cooking, cleaning and home health services, while they are unknowingly being signed up for hospice services, CMS stated in the toolkit.

Since unveiling the toolkit, CMS has been working to create additional, more specific social media campaign materials to improve public awareness of potential fraud schemes, including developing brochures for a national publication, Pryor said.

The agency anticipates more communication efforts to unfold on the horizon, he indicated.

“[It’s] helping to enhance the education and the beneficiary to inform them to not necessarily accept these kind of open invitations or marketing schemes to get these free benefits that were reported or presented to them as being provided by Medicare in the attempt to mitigate or to compromise their Medicare Beneficiary Identification (MB)] and have them signed up on a hospice fraudulently,” Pryor said. “When these [social media campaign] activities started late June and early August last year, we continued to enhance our education and beneficiary activities with more collaboration with our Office of Communications on this particular broad scheme. We’ll have more to follow in the future.”