Published in RINewsToday on June 8, 2026
As skyrocketing Medicare fraud schemes cost taxpayers billions each year, congressional leaders, federal agencies, and consumer advocacy groups intensify their efforts to combat aggressive scams targeting older Americans.
Experts estimate that Medicare fraud, waste, and abuse may cost as much as $60 billion annually. However, no federal agency publishes a definitive total amount because much of the activity goes undetected.
The growing incidents of Medicare fraud, waste, and abuse framed the discussion on June 3, 2026, at the Leon Mathieu Senior Center in Pawtucket, where more than 40 older adults gathered for the Fifth Annual Medicare Fraud Prevention Week event.
During the 75-minute presentation, three federal officials shared valuable information with the attending Medicare beneficiaries, designed to increase their awareness of fraud tactics and equip them with practical strategies to safeguard their personal and health care benefits.
The afternoon program was hosted by Rhode Island’s Senior Medicare Patrol (SMP), along with special agents from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), the Centers for Medicare and Medicaid Services (CMS), and the City of Pawtucket.
At the gathering, municipal, state, and federal leaders warned that Medicare recipients remain primary targets of fraudsters who use fake medical claims and identity theft. Specific types of fraud were highlighted, including durable medical equipment (orthotic braces, urinary catheters), genetic testing, and fraudulent billing by medical providers.
Learning to Spot the Warning Signs
Christine Anderson, Health Information Manager at the Rhode Island Office of Healthy Aging (OHA) and the leader of the state’s SMP program, said the program’s goal is to provide beneficiaries with practical tools to protect themselves and encourage them to be more proactive in reporting suspicious fraud activity, potentially reducing the success rate of scams within Rhode Island.
Anderson emphasized that scammers will often pose as representatives of Medicare, Social Security, or local human services offices to obtain or confirm Medicare numbers, which can be used to bill for unnecessary durable medical equipment such as back or knee braces.
SMP’s Program Manager urged attendees to review their Medicare Summary Notices (for Original Medicare) or their Explanation of Medical Benefits (EOMB), and to seek assistance from the SMP program and the Leon Mathieu Senior Center (or their local senior center) if they see unfamiliar charges.
“If something doesn’t look right, ask questions,” Anderson urged.
“We are grateful to the OHA, HHS-OIG, CMS, and the SMP for bringing this important information directly to our residents,” Donald R. Grebien, Mayor of Pawtucket said. “Education and awareness are critical in protecting older adults and preserving the integrity of the Medicare system.” It is one of the strongest defenses against scams targeting older residents,’ he says. Grebien pointed out that fraud can threaten both the financial security and well-being of seniors.
Echoing Grebien’s sentiment, Elizabeth Moreira, Pawtucket’s Deputy Director of Administration, said community education is key, stressing that awareness of the growing prevalence of scams is one of our strongest tools for preventing fraud. “Events like today give our community and caregivers the tools they need to recognize warning signs, protect their personal information, and report fraud before it can harm them,” Moreira said.
Federal Enforcement Efforts
HHS-OIG Special Agent Victoria Mens and Assistant Special Agent Lindsay Walford described their federal agency’s role in investigating fraud, waste, and abuse across more than 100 HHS programs, including health, social, and Medicare and Medicaid programs.
The federal agents also explained how they fight Medicare fraud, waste, and abuse.
They highlighted how the Office of Audit Services and the Office of Evaluation and Inspections publish reports on systemic problems including nursing homes lacking emergency power and using antipsychotic drugs to control residents.
To safeguard $2 trillion in federal healthcare funds, HHS-OIG conducts audits, evaluations, and criminal investigations.
The federal officials also cited prosecutions involving overbilling for medical equipment, large-scale catheter fraud schemes, and psychiatric billing for services that were never provided.
One of the most costly schemes involving urinary catheters was estimated to have resulted in attempted losses of about $4.5 billion, notes Walford.
During the presentation, Walford cited a Rhode Island case. She noted that Zynex Medical allegedly overbilled multiple payers about $873 million for TENS units and excessive supplies, leading to criminal charges against company leaders and a non-prosecution agreement with the company.
“A lot of that has been stopped, and so that money hasn’t all gone out, but that’s the tune and counting as to how much they’re attempting to pull out of the Medicare Trust Fund,” Walford said. She gave an overview of HHS-OIG accomplishments. Between April and September 2025, OIG work led to $2.2 billion in recoveries through settlements and criminal restitution. The agency said it returns nearly $13 for every dollar spent on oversight.
During the same period, investigators completed more than 900 investigations and issued hundreds of recommendations to prevent improper payments, says Walford.
Protecting Yourself
Mens urged seniors to treat their Medicare number with the same care as a Social Security number. “Don’t give out that information,” she warns. “If someone calls claiming to be from Medicare or says they are your healthcare provider, hang up and call back using a number you know is legitimate,” she says.
“Scammers rely on urgency,” Mens said. “Take time to talk with a family member, Medicare representative, or healthcare professional before making any decisions,” she says.
Jennifer Syria, Regional Administrator for the Centers for Medicare & Medicaid Services, pointed out that beneficiaries play a critical role in preventing fraud. “When you review your statements and notice unfamiliar charges, you become a valuable investigator in preventing fraud,” Syria said.
Syria encouraged residents to report suspected fraud and have key details ready, including provider names, dates of service, payment amounts, and Medicare Summary Notices.
“If you suspect you are a victim of fraud, our trained staff can meet with you to help resolve the issue,” says Mary Lou Moran, Director of the Leon Mathieu Senior Center. If you need assistance, call 401-728-7582. Moran notes that protecting yourself comes down to three key actions: prevent, detect, and report.
For more details about Rhode Island’s Senior Medicare Patrol program, call (401) 1-888-884-8721.
Tag Archives for OHA
Rhode Island PR Campaign to Reduce Older Adult Overdoses
Published in RINewsToday on February 16, 2026
Four months ago, the State of Rhode Island joined an estimated 5,000 community coalitions across the nation and U.S. territories to participate in the 2025 National Substance Use and Misuse Prevention Month. The Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services, organizes this annual federal initiative to highlight the importance of early intervention and community-based prevention strategies.
During November, the State launched its 2025 public awareness campaign titled No Matter Why You Use, aimed at preventing overdose deaths among adults ages 45 to 64 and older. This demographic group faces unique and often complex health risks that increase the likelihood of fatal overdose, making the campaign an important component of the Ocean State’s comprehensive strategy to reduce overdose deaths and improve lives.
The initiative focuses on aging adults who use substances, providing education and resources to help them feel more connected. “It’s also about eliminating stigma and amplifying the voices of those with lived experience,” said Cathy Schultz, Director of the Governor’s Overdose Task Force, in the statement announcing the program.
The statement also included comments from Linda Mahoney of the state’s Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH), who emphasized the campaign’s creative approach: “The approach we’ve used is designed to elicit a reaction of ‘this is my struggle,’ ‘that could be my friend,’ or ‘that could be my parent.’ The average person doesn’t typically connect substance use with older adults, but that’s part of the issue we face. If we can raise greater awareness of this reality, we can make meaningful strides in prevention, recovery, and eliminating stigma.”
Maria Cimini, Director of the Rhode Island Office of Healthy Aging, highlighting the state’s responsibility as its older adult population grows. “We must see the full humanity of older adults and confront the issues that too often remain hidden. Substance use is not a moral failing—it’s a public health challenge. By meeting people where they are, connecting them to care, and breaking the silence around stigma, we can build stronger, healthier communities for everyone.”
Data Reveals Rising Overdose Risks for Older Rhode Islanders
According to Joseph Wendelken, RI Dept. of Health’s Public Information Officer, national rates of accidental and undetermined fatal overdoses declined from 2023 to 2024 among adults ages 55–64 (from 51.8 to 41.1 per 100,000) and those 65 and older (from 13.4 to 12.5 per 100,000).
Wendelken noted that Rhode Island, however, experienced different trends. During the same period, the overdose rate increased among adults ages 55–64 (from 51.6 to 63.5 per 100,000) but decreased among those 65 and older (from 15.6 to 12.4 per 100,000).
While much of the national conversation about overdose focuses on younger populations, research shows that middle-aged and older Rhode Islanders often struggle with co-existing physical and mental health conditions, chronic pain, isolation, stigma, and limited access to care — factors that can contribute to rising rates of substance use and overdose, says RIDOH.
Among the key statistics driving the public relations campaign are findings from Rhode Island’s 2024 fatal overdose data. Individuals ages 45 to 64 are experiencing accidental drug overdose deaths at significantly higher rates than the statewide average.
Compared to previous years, the Health Dept. says that the rate of accidental drug overdose deaths continues to rise among individuals ages 55 to 64 in Rhode Island. Most overdose deaths in this age group (87%) occurred in private settings, such as homes.
Stimulants — including cocaine, crack cocaine, methamphetamine, and amphetamines — contributed to 65% of fatal overdoses in this age group, reflecting a growing public health concern beyond opioid-related deaths. Fentanyl was involved in more than half (51%) of fatal overdoses, underscoring its continued role as a primary driver of overdose deaths. A combination of fentanyl and cocaine contributed to 34% of overdoses in this population.
The greatest proportion of overdoses in this age group occurred among males (69%) and non-Hispanic white individuals (74%).
A Statewide Strategy to Prevent Overdose and Save Lives
“The No Matter Why You Use campaign raises awareness of substance use and overdose risks among middle-aged and older adults, provides clear prevention information, and directs Rhode Islanders to PreventOverdoseRI.org for treatment and recovery resources,” said Wendelken. Educational materials have been distributed to hundreds of community partners, including senior centers, healthcare providers, libraries, senior housing sites, and recovery community centers.
The No Matter Why You Use campaign is being led in partnership by the Rhode Island Executive Office of Health and Human Services (EOHHS), BHDDH, OHA, and RIDOH. .
This data-driven campaign supports Gov. Dan McKee’s Overdose Task Force “Roadmap,” which is built on four pillars: strengthening comprehensive prevention; expanding harm reduction and rescue efforts; increasing engagement in treatment; and supporting recovery,” Wendelken explained.
The state initiative is guided by cross-cutting strategies designed to promote an equitable response to the overdose epidemic. These strategies include embedding racial equity across all pillars; strengthening governance and community engagement; expanding data capacity and surveillance; and addressing social determinants of health throughout each pillar.
According to Wendelken, this evidence-informed approach aligns with Rhode Island’s broader overdose prevention strategy and ongoing efforts to save lives.
The state partnered with RDW Group on the No Matter Why You Use campaign. The initiative is based on formative research that included in-depth interviews with subject-matter experts and individuals with lived experience — including people in recovery, counselors, social workers, community advocates, and physicians. These authentic voices helped shape the campaign’s messaging, which emphasizes the impact of stigma, hopelessness, and emotional distress as common triggers for substance use among aging adults who may feel isolated or disconnected.
The campaign’s powerful, portrait-style imagery and first-person messaging acknowledge that people use substances for complex reasons — including isolation, pain, trauma, anxiety, and depression — while centering compassion at its core: No matter why you use, your life matters. Hope and help are here, adds RIDOH.
You can find stories of local Rhode Islanders sharing their powerful recovery stories on the RIDOH (go to https://pori.soapboxx.com).
Designed to help individuals feel safe, seen, and supported, the campaign connects Rhode Islanders to local treatment, recovery, and harm reduction resources at PreventOverdoseRI.org. Its media strategy uses data-driven insights from fatal overdose heat maps to target placements for aging adult audiences. Outreach includes digital advertising on social media, website and app display ads, local and streaming radio spots, and advertisements on gasoline pump televisions.
RIDOH notes that The No Matter Why You Use campaign also includes grassroots outreach to more than 250 organizations statewide. Its launch is part of a comprehensive and ongoing effort by Rhode Island to address substance use and related public health crises.
From Crisis to Recovery
The state’s new No Matter Why You Use campaign, aimed at reducing overdose deaths and addressing stigma among older adults, marks an important first step in combating substance use disorder, says Diane Dufresne, Director of the Pawtucket Prevention Coalition. The coalition is a community organization dedicated to addressing social issues such as substance use, poverty, and homelessness.
Dufresne emphasizes the importance of using precise, nonjudgmental language like “substance use disorder” to shape public perception and support recovery.
“The state’s campaign sloganis powerful because it centers compassion over judgment and makes one thing clear: every life is worth saving,” says Dufresne, who holds a degree in counseling and has been a certified prevention specialist for five years. She also brings more than 40 years of experience as a registered nurse, this extensive clinical background strengthening her work in substance use prevention and advocacy.
Drawing on her frontline experience, Dufresne agrees with the state’s assessment that substance use and overdose rates are rising among adults age 45 and older. She attributes this trend in part to limited harm-reduction education available to this generation.
“Many older adults developed addictions through legitimate opioid prescriptions and now face complex health challenges, including dangerous interactions with medications prescribed for coexisting conditions,” she explains.
Dufresne notes that shame and stigma are primary drivers of isolation among older adults, increasing the risk of fatal overdoses. “Older adults are more likely to use substances alone in private settings. “Younger people have received more harm-reduction education and better understand the risks of using alone,” she says.
Dufresne also highlights significant barriers to treatment, including transportation challenges, insurance limitations, technology gaps, and reduced mobility. Addressing these obstacles, she says, will require increased state funding and more targeted outreach efforts.
“Increased funding is necessary for community organizations to expand anti-stigma education, provide training opportunities, and connect older adults with treatment and recovery services,” Dufresne says.
The No Matter Why You Use campaign acknowledges the unique challenges facing this demographic, including limited exposure to modern harm-reduction practices, a higher likelihood of addiction stemming from prescribed opioids, and increased social isolation.
Dufresne advocates pairing Narcan distribution with anti-stigma education and recommends practical strategies to reach isolated seniors.
“Effective outreach should include combined Narcan and anti-stigma training in senior housing and community centers, along with door hangers that provide service information for individuals in private residences,” she says.
Above all, Dufresne stresses that saving lives must remain the priority.
“The act of saving a life should never be influenced by judgments about a person’s history of addiction or previous overdoses,” she says.
Advocates call for Governor to reject budget cuts they say would harm older adults
Published in RINewsToday on Oct. 28, 2024
As the state’s Office of Management and Budget (OMB) holds its Revenue & Caseload Estimate Conference to discuss the economic and revenue outlook for the upcoming legislative session, the Senior Agenda Coalition of RI (SACRI) warns of “onerous budget cuts” proposed by state agencies overseeing programs and services for Rhode Islanders. At press time, the state’s Medicaid and the Office of Healthy Aging offices proposed 7.5 percent budget cuts to be included in the upcoming fiscal year 2026 budget.
“It is unconscionable that at a time when our older population is growing – projected to reach one out of every four Rhode Islanders in a few years — to propose budget cuts for programs proven to keep them healthy and safe and that in the long term can save taxpayers money,” says SACRI Board Chair, Diane Santos.
According to Santos, the requests put forward by the Office of Healthy Aging (OHA) include a reduction in state funds for the Meals on Wheels home-delivered meals program projected to cause 13,000 fewer meals to be delivered to persons unable to shop and prepare meals; cuts in funding for local Senior Centers and programs for older adults; elimination of grants to provide security services in elderly housing; and decreased funding to support the Elderly Transportation program.
Santos warns that proposed changes in Medicaid eligibility guidelines are projected to cause hundreds of vulnerable older adults and persons with disabilities to lose state Medicaid coverage for their nursing home care and cause nursing homes, many of which are already struggling financially and face critical worker shortages, to lose millions of dollars if implemented. In addition, changes in the Medicaid CNOM (Costs Not Otherwise Matchable) program could reduce federal dollars that match state funding and impact hundreds of persons receiving home care and adult day services that help keep them living at home, the proposed cuts could result in greater spending in other areas.
For example, says Maureen Maigret, SACRI Policy Advisor, “Brown University researchers have shown that funds spent on home-delivered meals can delay or even prevent costly nursing home care.”
Over the years, Maigret noted that SACRI has worked to boost state funding to communities to assist them to operate local senior centers and programs. These serve hundreds of older adults and families across the state with a wide range of programs that keep older adults healthy, informed and connected to their communities, she noted.
SACRI has called for the state’s budget to provide ten dollars for each person aged 65 and over to Rhode Island’s 39 cities and towns, says Maigret, calculating that this amounts to about $20 per older adult. “The proposed cuts now being considered fail to recognize the increased need for these services due to the significant growth of our older population,” says Maigret.
Drawing a line in the sand
At press time, SACRI and its partners delivered a letter to Gov. McKee urging him to not balance the state budget on the back of Rhode Island’s older adults, stressing that the “potential ripple impact on families will be significant.
“Nonprofits and those who will be impacted need to know that SACRI and its partners are closely watching this process and are ready to advocate to protect programs and services which may impact our varied constituencies,” says Carol Anne Costa, SACRI Executive Director.
Costa continued, “The fastest growing demographic in RI is people over the age of 65. That is an obstinate fact. And cuts to the budget must be re-prioritized.” The Office of the State Ombudsman agreed, “If anything, OHA should be getting an increase, as they manage to complete all of their obligations on a shoestring budget. And kudos to Maria Cimini and her team at OHA for the outstanding work they do,” says Kathleen Heren, the RI Ombudsman.
Costa noted that OHA is Rhode Island’s designated state unit on aging. It serves as the chief advocate for older Rhode Islanders, adults living with disabilities, and family caregivers. “Prioritizing reductions in spending in areas not directly tied to OHA’s core mission or that would not harm vulnerable older adults and persons with disabilities dependent on Medicaid to meet their long-term care needs is clearly a place to start [in determining budget cuts]. Administrative expenses and the millions of dollars being paid out to consultants could be heavily scrutinized for budget reductions,” she says.
Adds Mirelle Sayaf, Executive Director of Ocean State Center for Independent Living (OSCIL), “The proposed budget cuts pose a serious threat to the mission of the OSCIL, which is dedicated to supporting individuals with disabilities. Reducing funding, along with changes to Medicaid eligibility and essential programs, will harm those we serve. These cuts jeopardize vital services such as home care, nutritional support, and community engagement initiatives that empower individuals to live independently and maintain their quality of life.”
“Cutting the budget for the OHA when its resources are already extremely stressed to fully meet the needs of a growing older population is unjustified,” charges SACRI’s Maigret, who is also a former Director of the Department of Elderly Affairs.”
Maigret also opposes changes to Medicaid eligibility after advocates have spent years to ensure persons in need of long term supports and services have access to a range of affordable options, and avoidance of long wait lists for service. She calls for increasing resources to the Rhode Island’s cities and towns to help them support local programs for older adults and increasing eligibility for the Medicare Savings Program so lower-income persons on Medicare can afford needed healthcare. But, Maigret also says that housing needs of older adults must be considered when allocating housing funds.
Food & Shelter important, too
Gerontologist Deb Burton, Executive Director of RI Elder Info also has some thoughts about the state’s proposed budget cuts.
“Cuts to Meals on Wheels that cause our most vulnerable, at-risk, elders to go hungry are simply unconscionable. Taking meals away from our elders cannot happen,” says Burton.
“We must bring back the housing stabilization unit for older adults. Older adult homelessness has increased more than 400% since COVID hit and rents skyrocketed. Rising housing costs, fixed incomes, and wait lists of 2-8 years for affordable elderly housing have all contributed to this crisis. In addition to these challenges, the application process for getting an apartment is onerous and nearly impossible if one does not have access to the internet,” adds Burton.
Eviction prevention is critical in addressing the elder homelessness issue, says Burton, noting that private sector partnerships and philanthropic donations can support a housing stability unit for older adults, ensuring sustainable funding for eviction prevention programs.
“We must find the strength and compassion to provide the funding necessary for food and shelter for our most vulnerable friends and neighbors. If we don’t, what does the future hold for ourselves?” asks Burton.
A Final Call
“The November Revenue and Caseload Estimating Conferences will provide updated projections to inform budget development which will help set priorities. However, RI’s most vulnerable and fastest growing demographic must be prioritized in finalizing the FY2026 budget,” urges Costa.
Herb Weiss 