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Social Engineering being used to commit Medicare fraud

The New York StateWide Senior Action Council (StateWide), an organization dedicated to advocacy for the rights of seniors in New York State, is raising awareness of 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.

“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.

“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.

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