Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered Podcast. I'm Dr Neha Pathak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine.

Have you ever wondered about the phone calls, text messages, or emails full of special offers that you or your loved one is receiving? Maybe you've been approached about an online deal for a much-needed wheelchair or brace and wonder if the deal is too good to be true. Are you concerned that an older loved one is vulnerable to scams? Do you think that they're unsure of who they can trust and when they might share private information? Or maybe you're asking yourself, are any of those Medicare phone calls actually legitimate? You're not alone. Fraud specifically targeting older adults is rising at an alarming rate, with elaborate schemes designed to steal personal information, drain life savings, or even risk your health with counterfeit medical equipment.

Today we'll unpack the most common scams affecting seniors, from fake Medicare calls to deceptive billing and equipment fraud. We'll also review simple yet powerful steps families can take to stay protected. If you've ever wondered, "How do I know that this is safe or this is a scam?" or you have a loved one that you're concerned about, this episode will give you the clarity and tools to help keep you and your loved ones safe.

First, let me introduce my guest, Robert (Bob) Blancato. Bob Blancato is the president of Matz, Blancato & Associates. He also serves as the National Coordinator of the bipartisan 3,000-member Elder Justice Coalition, the Executive Director of the National Association of Nutrition and Aging Services Programs, and the National Coordinator of the Defeat Malnutrition Today Coalition.
Bob has long been recognized as a national advocate with policy expertise on behalf of older adults. Welcome to the WebMD Health Discovered Podcast, Bob.

Robert (Bob) Blancato: Thank you very much, Dr Pathak, and I appreciate the chance to be here and appreciate the work you're doing in this area.

Pathak: Well, I think this is such an important topic. But before we jump into it, I'd love to ask about your own health discovery with regard to your advocacy and all of the work that you do. What questions or issues arose that inspired this work?

Blancato: Well, you know, I'm not so sure it was a discovery as much as it was an acceptance of something which I had long believed. And it took a long time for policy to catch up, which is the nexus between nutrition and health. We've assumed it, but it's taken a long time for it to reach the point where we would have policy changes that reflected it.
And what really drove this conversation was when, back in 2022, after some work that our malnutrition coalition did, we discovered that one in two older adults was either a victim of malnutrition or was at risk of malnutrition. And this came as a big surprise to people. You know, conversely, good nutrition can promote good health, but bad nutrition can obviously create malnutrition.
So the Centers for Medicare & Medicaid Services adopted a first-time malnutrition quality measure in the inpatient hospital rule to make sure that people who go to hospitals and are diagnosed and treated there don't get readmitted because there's no activity at the local level they can connect to.
So we spent a lot of time focusing on that. And I guess more to our topic today, I think the other thing I've noticed is that we've had a great focus on healthy aging in this country, which is appropriate, but we cannot forget those issues that serve as the opposite of healthy aging, like elder abuse, neglect, and exploitation.
So those are my two things that I've worked on.

Pathak: So much of what you say resonates with me as a caregiver for four elderly parents/in-laws. And so really thinking about optimizing their health through nutrition and activity. And then, oftentimes, we get questions as their children around scams or questions around phone calls that they're getting, whether it's for nutrition programs or otherwise.
So I can see how all of these threads really tie together. I'd love to then jump into our discussion for today and really focus on the common types of scams elders face. Just starting broadly, what are some of these scams or fraudulent activities that affect older adults in the healthcare system today?

Blancato: First of all, we'll start by saying there's too many. There was a publication called Money Supermarket that I saw that said an older adult is a victim of fraud every 50 seconds in this country.
And so when we talk about specific healthcare fraud-type things under Medicare and Medicaid, things like deceptive billing for fraudulent services, any theft of personal information—which happens way too much in the whole scam arrangement—those that involve counterfeit and often unsafe drugs.
When people are in pursuit of discounts and don't have enough knowledge of where to look, the scammers find them. And often, these drugs are counterfeit and would not be allowed in our country under our regular standards for drugs. Then there are those involving telemedicine fraud—getting unneeded services, being linked to bad telehealth actors, and again, theft of personal information. That runs through pretty much all the scams that we'll talk about today.
Those that involve things like equipment scams, which are particularly disturbing when you consider the fact that not only is it an issue about fraud, it's a danger issue. If you end up with bad braces or a bad wheelchair or something that could harm you, that's a double-jeopardy scam that we should be particularly cautious of.
Any scam that involves a loss of funds is going to impact an older adult much more. You know, in our work over the years, we're astounded at the degree to which people lose money in scams—entire life savings in some cases. So all of them have a common thread of losing either information or real money, and it's a growing concern.

Pathak: I feel like I'm ticking every box as you are speaking as a caregiver. So some of these things I do notice—these texts directed at me because my name is often on some of the medical forms for my parents. Certainly, the calls that my parents get, the texts that they get, just watching TV and seeing commercials for various types of equipment.
And often I can say that from my standpoint as a caregiver watching my parents and my in-laws, really, people are desperate for information. Even someone like me who's in the healthcare system—it can be very confusing to navigate. It is really easy to fall into some of these traps.

Blancato: I remember going through the same situation with my own family—my own father and mother—and my father in particular, who was an anesthesiologist in New York for many years, reached a point where he was asking me to help him with his financial matters.
And I remember going to his apartment and looking over the mail that he had gotten and the solicitations that he had gotten that were so outlandish—fear written all over the envelope. Things like, "You could lose your Social Security if you don't respond to this piece of mail."
These are the kinds of things that older adults—particularly those who live alone, who don't have the benefit of a caregiver—can fall victim to more easily. That's why, in our efforts to prevent scams, we've got to address the issue of social isolation and loneliness and the need to have abilities to address that issue and provide older adults with whatever it takes to have some second group of people who can look out for them as they're going forward.

Pathak: So let's dig into one specific type of Medicare scam. Medicare imposter scams are a big concern, where criminals pose as Medicare representatives. Can you explain a little bit more about how this type of scam works? What are some of the red flags that older adults and those caring for them should be thinking about and watching out for?

Blancato: The number one thing, for sure, is: don't answer that call. If a call comes in—I mean, I tell people, if they don't have caller identification on their phone, it's very important to get that. Because those people who answer the phone instinctively, like a lot of older adults, they're used to that situation. They're used to that meaning communication.
So if they call first, that's the first red flag, okay? Because the federal government never calls you. We need to remember that—the federal government never calls you. And if you do answer the phone—and I encourage people not to—but if they do, listen. Once they use the word "Medicare" in any way, shape, or form, then you say, "Are you part of the Centers for Medicare & Medicaid Services? Have you been approved by the federal government to do this?" and see how long it takes them to give you an answer. Any more than two seconds—right off the bat—red flag number two.
And number three: after you've hung up, and you're still curious, call back the number that came in and note that if it doesn't exist, then do two things—report it accordingly, tell your friends and colleagues what you went through, and keep them from going through the same situation. But it normally begins with something as simple as a phone call. And these days, some of these scammers have the capacity to give you, if you did have caller ID, the same first three digits that you have on your phone.
So it sounds like you have a neighbor or a friend calling you up. You’ve got to be very conscious of answering that phone, because if you say anything more than “hello,” you’re likely to get into some kind of trouble.

Pathak: So you mentioned report. This type of encounter, where do you suggest people report these encounters to?

Blancato: First of all, since this is an area called elder abuse and scams, every state has Adult Protective Service people — local, state, county — they should be among the first to be contacted. Medicare itself has a line that you can report fraud to, and people should have that information.
Now that we're in open enrollment season, that information becomes more available. If you're in a nursing home and you run into a scam, you have the long-term care ombudsman, who are there to investigate complaints involving all forms of abuse, whether it's physical or financial or whatever it may be.
The Senate Special Committee on Aging, whose ranking member is Senator Gillibrand from New York, has a senior fraud hotline that people use a lot. We communicate with them a lot from our vantage point. And you know, I will tell you from my vantage point as a national coordinator of the Elder Justice Coalition, we get plenty of people calling us with their own stories.
And we send them appropriately to have somebody look into it and to address it. But the fundamental thing to remember in this topic is you don’t stop what you don’t report. You can’t stop it if you don’t report it. And we have way too many cases of all forms of elder abuse that go unreported, and we really have to work to do a better job at preventing other victims from being impacted.

Pathak: That's a really important point. So can you tell me a little bit about how these medical equipment scams work and what are some of the risks to seniors?

Blancato: I mean, clearly one of the risks is if they ask you for Medicare information first before they make the offer of the equipment — okay, that’s a red flag right there. And then, the whole question of the equipment. One of the questions would be if you don’t give your Medicare information, that you would say, “Is Medicare gonna cover this?”
Even without saying that you’re on Medicare, you need to have those sorts of benchmark questions asked. But I think here, the uniqueness of this particular scam is the danger it can create, as I mentioned before, to the older person getting that bad equipment. Because there’s no liability on the part of the people who are pushing those bad wheelchairs or walkers or canes or whatever it may be.
And you have no recourse. You may have shelled out money for something that proves to be dangerous to your health, and you have no way to turn around. And I understand this is getting to be more prolific now than it was even a couple of years ago, and I think it’s very important that people be aware of it and also make sure that whether you as the individual do the reporting or someone in your family or some colleague that you’re close to — somebody has gotta report it so they can do what the federal government does well: they break up these scams.
They’re very sophisticated. So that one in particular has got a two-pronged nature — whatever you lose on the money side and whatever danger there is to your health if you get the wrong equipment.

Pathak: I'd love to shift us now to sort of thinking about the healthcare system itself. So you mentioned earlier billing fraud as an issue, and that’s when providers bill for services that weren’t provided or they upcharge for more expensive treatments. So can you tell us a little bit about what we know around how widespread this problem is and how that impacts older adults on Medicare?

Blancato: Well, first of all, according to the Department of Health and Human Services, going back to fiscal year 2023, they estimated improper payments to both Medicare and Medicaid totaled over $100 billion. In June this past year, the Department of Justice announced charges against 3,324 defendants in healthcare fraud schemes with over $14.8 billion in intended loss had they pursued and been able to go forward with their scams.
You know, one in particular they have broken down into different categories for billing. Urinary catheters cost the federal government, for false billing, up to $2 billion just in 2023. So what’s the impact on the older adult? Well, it depends on which bill comes in.
If the bill comes to them and they were unneeded services, that’s one issue and you need to report that to the Senior Medicare Patrol as quickly as possible. But I think in a broader sense, it’s draining resources from Medicare that leaves less for those who legitimately need it. That’s where we should be concentrating our efforts — to crack down.
On a bipartisan basis, I remember in 1995, when I was happy enough to run the White House Conference on Aging for President Clinton, his big announcement that day was Operation Restore Trust — going after all the fraudulent activities that were going on at that time in the Medicare and Medicaid programs and announcing new initiatives to cut back on those.
And the real trick is to be able to have this reported through the channels I mentioned before — like Adult Protective Services, Senior Medicare Patrol, Medicaid — and you know, it’s not new. In fact, we should be farther along than we are in how to combat this.
But it’s gonna take a lot of vigilance on the part of the federal government, and unfortunately, the scammers and unscrupulous people always seem to be ahead of the good people in this business, and it’s unfortunate.

Pathak: So talk to us about another thing that I’ve seen a little bit more around in the suburbs of where I live — what we call rolling labs. So you’ll see these mobile clinics, particularly in areas where a lot of seniors might be, and they’re offering a variety of tests. So can you tell us a little bit about that?

Blancato: When you talk about rolling labs, that’s a fraudulent scheme where providers use mobile equipment to perform medically unnecessary tests, and then they bill Medicare. They use vans and freestanding clinics to offer free wellness screenings. They find these older adults at health clubs, at their church, even in nursing homes — we found that.
And these tests, like noninvasive physiological and vascular tests that they offer — whether they’re needed or not — the scammer says, “We’ll waive the copayment.” They have no authority to do that, and they shouldn’t even be bringing that up, but they just make it sound even more attractive: “Don’t worry about a copay, we’ll take care of waiving that for you.”
And some of them use physicians to certify questionable diagnoses so they can bill Medicare. And again, Medicare only pays for services and tests that are reasonable and necessary for diagnosis or treatment for medical conditions.
Medicare does pay for lab tests that are medically necessary, but also preventative screenings such as the annual Medicare wellness exam. But the very fact that you’ve reached a point where you can infiltrate a senior center or a place where older adults come — one of the first things that I would recommend, and I work in this space of nutrition programs and senior programs — the first line of defense are the people who run the programs.
They shouldn’t let them in. They should know, they should interrogate them about what their purpose is, and if there’s any doubt about it — don’t let them through the front door. We’ve got to be very vigilant about that because it is true — they manage to find the most vulnerable people and make the most fraudulent pitches you could possibly do.

Pathak: I imagine that we’re probably going to see maybe more of this in the “food as medicine” space now that we’re really thinking about tailored prescribing of medical meals. How do you sort of think about this as a future concern?

Blancato: I mean, it’s exciting as a future improvement. The whole concept of making America healthy again has wonderful potential if it’s properly developed, properly regulated going forward. Even right now we have an issue going on between food as medicine, food as medicine, medically tailored meals — there’s a whole range of different things. We’ve got to come to some consensus on the definition of what it includes and why it’s being offered.
We know in our world, we deal with a lot of people who provide congregate and home-delivered meals to older adults. Some of them are experimenting with medically tailored meals. One of the first things you’ve got to establish is: Is the cost too high to be able to do it? And is the benefit going to work itself out? And then you’ve got to be careful about fraudulent entities that are producing these meals to make sure they’re meeting the standards that are necessary.

Pathak: So we’ve talked a lot about Medicare. I’d love to get your thoughts on fraud that specifically targets Medicaid beneficiaries. Can you highlight some of those tactics that scammers use?

Blancato: Yeah, that’s a good point. I think where that’s beginning to show up more is in one of the more important developments — a very positive development — that occurred with Medicaid about maybe four years ago, when Medicaid stopped spending more on institutional care than it did for home and community-based care.
That’s what the advocacy world wanted. That’s what the caregiver world wanted. That’s what older adults wanted — the ability to remain home or in their community to get care. Well, that situation led to a waiting list problem across the country — totaling almost 800,000 people who are now on a waiting list waiting to get these services.
And we’ve got to be particularly vigilant about who it is that’s providing these services — community-based services and the like. And we also have to be very careful about making sure that we are addressing the workforce issue when it comes to addressing issues around Medicaid and proper care.
People need to be properly licensed and properly able to do that kind of work. And that’s a form of fraud that we have to be cognizant of going forward. But because so much is new in this home and community-based care space and Medicaid-managed care, we just gotta make sure that the right actors are doing the right thing in those areas.
Because Medicaid is the single largest health insurance program we have. And what’s going to be interesting to see is when the provisions of what they call HR 1 take effect — with work requirements and other changes — what’s that going to do to the whole situation about providing those services? Are we going to be finding more challenges than we did before?
But you know, whether it’s Medicare or Medicaid, they’re both studied carefully about the fraud situation. But Medicaid — considering more economically vulnerable people are in Medicaid — we should be doubly careful, making sure they’re protected.

Pathak: So can you tell us a little bit about scams from impersonating tech support to grandparent scams? What should we know about these types of scams?

Blancato: Those two in particular are rising to higher levels now with the tech scams. You know, here you have criminals impersonating tech support representatives from bona fide companies, you know, that are household names like Microsoft and things like that, to trick people into paying for unnecessary services.
Again, it's all about how this whole process starts. The minute you shut it down, the safer you are. But the minute you open up the conversation in any way, shape, or form and do things like giving people remote access to your computers — I mean, you look at your computer and you see a fake pop-up message come, or a fake email come, or a phone call that says you’ve got a virus on your computer. Then they ask you for a gift card or something to pay in cash to fix the virus. I mean, this is so pervasive, so prevalent.
And you have to be so on top of this stuff. It is amazing how new some of these techniques have been. And you know, we talk about the need for older adults to be more tech-savvy. That’s all fine. We love that and that we’re trying to bridge the digital divide in rural America and places like that.
Well, that comes at a price. You’ve gotta be tech-savvy not only in how to hit the buttons and do the right things in typing or whatever, but to avoid these same kinds of tech support scams.
And then the grandparent scam — that is one that has appalled me for years. I am just astounded at how successful that can be. Where one or more insidious scammers pose as grandchildren saying that they found themselves in trouble in Canada or some other place, using a spoof — a spoof caller ID — “I need legal fees ’cause I’m in trouble,” “I need a medical procedure ’cause something happened to me when I was on this trip,” and now they’re using AI technology to mimic the voice.
And that itself is spooky. So one of the things that people have recommended, and I think this is a good idea, is to have, between a grandparent and a grandchild, a code word to verify their identity. Because the overlap is the older person becomes the victim, usually from the standpoint of losing financial benefits and so on.

Pathak: We started this conversation talking about loneliness and isolation and how we want to be providing ways to combat that loneliness in our elders and older adults. And it strikes me that it’s really, really, really sad that part of what the advice we have to give to our elderly loved ones is to not answer the phone and be really suspicious when someone calls. Because I think a lot of them did grow up in a time where they really valued trust and helping others.
So how do you sort of think about this from a societal level?

Blancato: And that’s a great question, and it’s a question that if you can find ways to keep the isolation and loneliness from happening to begin with, that’s critical. What community resources are available for an older adult, whether they’re in a community or in their home? Example again — focusing on nutrition programs.
For the older adult who goes to that senior center and gets their meal — we did a survey one time, and I went, in fact, and talked to a couple hundred older adults myself. I said, “What’s the main reason you come here when you come?” You know what the answer was? Socialization. Fellowship. Connecting with people. Same thing with home-delivered meals. It isn’t just dropping off a meal. It’s more than a meal. It is a safety check.
During the pandemic, there were all kinds of companies that found their way into providing and helping aging service programs offer things like tablets to keep older adults connected — virtual meals, things like that. You know, things that are very important. So it’s a matter of trying to address it early.
And the other part too is the important role of caregivers, and also not only providing care, but also opening up opportunities for community activities for an older adult to keep them from being isolated.
And another place that you’d be surprised — if you offer an older adult a volunteer opportunity, a lot of times they take it, and that becomes a really rewarding thing for them, even if it’s episodic, even if it’s once a week or whatever it may be, because instinctively an older adult will respond to that because they care about others.
They’re the ones who have grandchildren and great-grandchildren, right? And they understand the importance of having community service available to them. And in our older adult nutrition programs, we have many, many older volunteers who come in, and they are vital to the whole thing.
But it’s a question of recognizing, community by community, where your aging network is. It’s called an aging network for a reason. It’s not about a network of providing services; it’s about a network that connects the people they serve to each other and to what’s available to them to help them live more independently in their communities, which is a goal that we all seek.

Pathak: So I would love, as our time together comes to a close, if I could hand it over to you for just some practical steps that older adults and their families can take to protect themselves from the variety of scams and fraudulent activities we talked about today.

Blancato: I’d be happy to, and some of them we’ve talked about, but I’ll repeat some of them. First of all, if something sounds too good to be true, it is. And when you’re older, as an older adult, you remember that saying, and a lot of times it was true then — it’s true now. Stay suspicious long enough to be able to figure out whether or not something is not right.
Get caller ID. Caller ID is vital at this point, particularly what’s coming in. Close any window with an odd pop-up if you are back on your computer and working, okay? Never, ever give out any information, including granting remote access of any kind or giving any information that’s personal or financial in nature — your Medicare card number, anything of that nature.
Be suspect of any request for payments that somebody may make unsolicited. Keep your antivirus software up to date, okay, to make sure that nobody’s telling you you have something when you don’t. And then, of course, I think the final thing is report. Report, report — cannot do enough.
And I commend you for having this focus today. I think it’s very important, and I hope that we’ve maybe averted some scams from happening to people. Because what I’ve always said in my years of working in this space — a victim of elder abuse of any kind is never the same after the abuse, and we should be working to prevent victimization.

Pathak: That is such a powerful, powerful point. And so then I’d like to ask you one last question relating to that. So we want to do our best to prevent that. We all know that prevention is one of the most important things you can do. But what should people do if they have been taken advantage of? How should we deal with that emotionally for the person who suffered that abuse, and then also just logistically, being able to protect them now that a breach has happened?

Blancato: Well, that first point is very important. Blaming a victim is never any good. For someone who fell victim to a scam, if anything, a reassurance to some extent is that we’ve heard a lot about this. You know, don’t think you’re alone. This is going on more than we think. But then it’s going to be a question of the reporting issue that I mentioned. And let’s say it goes really far to the point where it’s a criminal case.
There are agencies on aging in every single state and county in this country, and they live to provide services and help to older adults. And they’re getting more and more involved in this particular area to help prevent these scams and financial abuse from happening to older adults.
But, you know, just having them understand that whether it’s on this program or other work that goes on, we have their back. We want to make sure they’re protected, and we’ll do all that we can, resource-wise and otherwise, to keep them from being victimized.

Pathak: Bob, I just want to thank you so much for your time today, for all of the really critical information, and for that powerful message about how to provide support. So thank you so, so much.

Blancato: Thank you for having me, and thank you for having this podcast. Thank you very much.

Pathak: Before we close today’s episode, I want to highlight three key takeaways from my conversation with Bob Blancato. First, if something sounds too good to be true, it probably is.
Sometimes those miracle deals and savings come our way when we’re at our most vulnerable or navigating a health crisis, but it’s important to trust your instincts and be a little skeptical. The fact is, the federal government will never call you asking for your Medicare number or payment. If this happens to you, simply hang up, verify, and report it.

Caller ID and skepticism are your first lines of defense. Second, many scams succeed because people experience shame and embarrassment and are unsure of what to do next or who to ask for help. So it’s important to talk about it if you or someone you care about has been the victim of a scam or is someone who continues to receive suspicious calls, emails, texts, letters, or offers.

Sharing this experience with family, friends, or adult protective services is critical, because the fact is we can’t prevent what we don’t report.
And finally, scammers prey on loneliness, fear, insecurity, and isolation. That’s why staying connected with community is so powerful. Staying connected is one of the simplest and strongest ways to stay safe.

In an age of online scams, find your local senior center and nutrition programs, participate in community events, volunteer opportunities, and fight isolation with connection.
To find out more information about Bob Blancato and The John A. Hartford Foundation, make sure to check out our show notes.
Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you’d like to send me an email about topics you’re interested in or questions for future guests, please send me a note at [email protected].

This is Dr Neha Pathak for the WebMD Health Discovered Podcast.