California Health Advocates

04/13/2026

In case you missed it, check out our April Newsletter! 📬🌷🙂 It's packed with important Medicare updates!

Here's a snapshot of what's inside:

💰 Medicare Advantage Overpayments — MedPAC projects Medicare will overpay Medicare Advantage plans by $76 billion in 2026 — about 14% more than what traditional Medicare would cost for the same beneficiaries. Find out what's driving it.

🔄 Wrong Plan? You May Be Able to Switch — Did you enroll in a Medicare Advantage plan using Medicare Plan Finder and discover your doctor isn't in-network? A new, temporary Special Enrollment Period (SEP) may let you switch plans or return to Original Medicare. Learn if you qualify.

📋 Thinking About Switching to Original Medicare? — Don't assume you can get a Medigap plan to go with it. Find out when you're guaranteed access — and when you're not — before you make any moves.

🏠 Protecting Home & Community-Based Care — Federal funding cuts are threatening the Medicaid home care services that help older adults and people with disabilities live independently. Learn how these programs are not "hotbeds of fraud" but rather reflect four decades of bipartisan federal policy, save state money and have significant safeguards against fraud.

⚠️ H.R. 1 & Dual Eligible Californians — About 1.6 million Californians rely on both Medicare and Medi-Cal. Here's what the new federal budget law means for them.

🧬 Genetic Testing Scams Are On the Rise — Scammers are showing up at health fairs, senior centers, and churches offering "free" DNA tests. Real cases in California show Medicare being billed up to $32,000 per person. Learn the red flags and how to protect yourself.

📅 Upcoming Free Webinars — Including a Medicare prescription cost-saving webinar on April 23 and a Medicare Fraud Prevention Week event on June 3!

Read the full newsletter here ➡
https://mailchi.mp/cahealthadvocates/medicare-advantage-overpayments-to-reach-76-billion-in-2026?e=[UNIQID]

04/11/2026

In new rules released by CMS, the Trump administration weakened some key consumer protections and gave big insurers a pay bump on the backs of taxpayers.

Though we're disappointed in the additional overpayments to Medicare Advantage plans, we acknowledge a positive policy win from the rule that Families USA advocated for to crack down on insurers’ ability to fabricate diagnoses so that patients appear sicker and they get paid more.

We hope to work with Congress and this administration on reforms like this to rein in the actual waste, fraud and abuse prevalent in the Medicare Advantage program.

04/10/2026

📧 Be careful of fake emails from "your bank" or "Medicare"!

Before clicking a link, ask yourself:
❓ Did I request this information?
❓ Is the sender’s email address correct?
❓ Is there a sense of urgency or threats?

Learn more: https://bit.ly/40T4TQ4

04/09/2026

🚨 Major hospice fraud scheme dismantled in Los Angeles — and California is holding the fraudsters accountable.

Governor Newsom and Attorney General Bonta announced criminal charges against organized crime networks that used stolen identities to fraudulently bill Medi-Cal for hospice services that were never actually provided.
Here's what happened:

🏥 14 fraudulent hospice providers were involved in the scheme
💰 More than $267 million in improper claims were paid with state and federal funds
🔍 California's fraud detection systems caught the scheme, stopped payments, suspended providers, and revoked licenses
🚔 284 criminals have been arrested as part of California's broader hospice fraud crackdown
🔒 Over 280 hospice licenses revoked in the past two years, with 300 more providers under investigation

California has built one of the most comprehensive hospice fraud enforcement efforts in the country — including a multi-agency Hospice Fraud Task Force, a moratorium on new hospice licenses, advanced data analytics, and strict provider enrollment checks.

This case is a strong example of what targeted, evidence-based fraud enforcement looks like in practice — protecting vulnerable Medi-Cal members, preserving critical resources, and holding bad actors accountable.

To report suspected Medi-Cal fraud:
📞 (800) 822-6222
📧 fraud@dhcs.ca.gov
🌐 dhcs.ca.gov

To report suspected Medicare fraud, call our California Senior Medicare Patrol (SMP) 📞 (855) 613-7080
🌐 californiasmp.org



https://www.gov.ca.gov/2026/04/09/california-stops-major-hospice-fraud-scheme-in-la-brings-criminal-charges-to-hold-fraudsters-accountable/

04/08/2026

The Senior Medicare Patrol (SMP) is warning the public about scammers targeting assisted living facilities and nursing home residents and signing them up for hospice, even though their life expectancy exceeds six months.

⚠️This is dangerous because if you are enrolled in hospice, you cannot receive care that could cure, like cancer treatments, surgeries, or even some medications.

🔍 Be sure to check your Medicare statements and see if you are being charged for hospice services.

If you find you are and shouldn't be, please contact our California Senior Medicare Patrol (SMP) at 1-855-613-7080 or online at californiasmp.org.

04/06/2026

Remote patient monitoring (RPM) covers a wide variety of services a provider may offer to help monitor or assess certain chronic conditions. SMPs are hearing about RPM claims appearing on Medicare statements, like the Medicare Summary Notice (MSN) and/or Explanation of Benefits (EOB), where the beneficiary does not believe they received or agreed to the services.

If you see any RPM claims on your Medicare statement that you did not agree to, contact our Senior Medicare Patrol (SMP) at 1-855-613-7080.

04/03/2026

📬 Our April Newsletter is out 🌷 — and it's packed with important Medicare updates you won't want to miss!

Here's a snapshot of what's inside:
💰 Medicare Advantage Overpayments — MedPAC projects Medicare will overpay Medicare Advantage plans by $76 billion in 2026 — about 14% more than what traditional Medicare would cost for the same beneficiaries. Find out what's driving it.

🔄 Wrong Plan? You May Be Able to Switch — Did you enroll in a Medicare Advantage plan using Medicare Plan Finder and discover your doctor isn't in-network? A new, temporary Special Enrollment Period (SEP) may let you switch plans or return to Original Medicare. Learn if you qualify.

📋 Thinking About Switching to Original Medicare? — Don't assume you can get a Medigap plan to go with it. Find out when you're guaranteed access — and when you're not — before you make any moves.

🏠 Protecting Home & Community-Based Care — Federal funding cuts are threatening the Medicaid home care services that help older adults and people with disabilities live independently. Learn how these programs are not "hotbeds of fraud" but rather reflect four decades of bipartisan federal policy, save state money and have significant safeguards against fraud.

⚠️ H.R. 1 & Dual Eligible Californians — About 1.6 million Californians rely on both Medicare and Medi-Cal. Here's what the new federal budget law means for them.

🧬 Genetic Testing Scams Are On the Rise — Scammers are showing up at health fairs, senior centers, and churches offering "free" DNA tests. Real cases in California show Medicare being billed up to $32,000 per person. Learn the red flags and how to protect yourself.

📅 Upcoming Free Webinars — Including a Medicare prescription cost-saving webinar on April 23 and a Medicare Fraud Prevention Week event on June 3!

Read the full newsletter here ➡
https://mailchi.mp/cahealthadvocates/medicare-advantage-overpayments-to-reach-76-billion-in-2026?e=[UNIQID]

04/03/2026

Medicare now lets you create or log in to your account using ID.me, CLEAR, or Login.gov. These are free services that verify your identity and help protect your information.
Because these sites are connected to your Medicare number, you'll be asked for sensitive personal information, including:
• A driver's license, state photo ID, or U.S. passport
• Your Social Security Number (SSN)
• A photo or video of yourself

Unfortunately, this makes the process a prime target for scammers. 🔍
WATCH FOR THESE SCAMS:
• Fake Emails & Texts: Scammers send official-looking messages urging you to click a link to "verify your account" or claiming there's an urgent issue with your benefits. Don't click. It's a trap.
• Fake Websites: Fraudulent sites are built to look just like government pages. They'll ask for your login details, steal your personal and medical information, or even charge fees for services that are completely free.
• Unsolicited Calls: Scammers may call claiming you need to activate your new Medicare login. Medicare will NEVER call you first to ask for personal information.

PROTECT YOURSELF:
• Always start at Medicare.gov. Type it in yourself, never follow a link.
• Only trust websites ending in .gov.
• Never share your SSN or Medicare number with anyone who contacts you first.
• Report suspicious activity to your local Senior Medicare Patrol (SMP).

04/01/2026

03/31/2026

🌞
Did you sign up for a Medicare Advantage plan this year using Medicare.gov's Plan Finder — only to find out your doctor isn't actually in the network? You may have a second chance to make it right. 😁

Medicare created a new, temporary Special Enrollment Period (SEP) for 2026 specifically for people who enrolled based on incorrect provider information in the Medicare Plan Finder. Because this provider directory feature is brand new, some of the information hasn't been accurate — and Medicare is giving affected beneficiaries a way to fix that.

Here's what you need to know:

✅ Your Medicare Advantage plan must have started between January 1 and December 1, 2026
✅ You must be within your first 3 months of coverage
✅ You must have enrolled using the Medicare Plan Finder on Medicare.gov — not a plan's own website
✅ You discovered your preferred doctor is not in your plan's network

If you qualify, you can:

🔄 Switch to a different Medicare Advantage plan
🔄 Return to Original Medicare with or without a Part D drug plan
📅 Your new coverage starts the first day of the following month

To use this SEP, call 1-800-MEDICARE (1-800-633-4227) — only Medicare can process this enrollment, not your plan directly.

And if you'd like free, personalized help figuring out your options, contact your local Health Insurance Counseling and Advocacy Program (HICAP) — California's free, unbiased Medicare counseling program at 1-800-434-0222.

Read more 🔗
https://cahealthadvocates.org/surprised-to-find-your-doctor-not-in-your-ma-plan-you-may-qualify-for-a-new-special-enrollment-period/

03/27/2026

Are you looking for a way to make a difference in your community?

California Senior Medicare Patrol (SMP) can match your skills with different program needs! Contact us at 1-855-613-7080 - Join our Team! 😁🌟

https://www.youtube.com/watch?v=oK5W8_xKjBE

Interested in making a difference, meeting new friends and joining a passionate team to empower your community? Volunteer with our California Senior Medicare...