SMART SENIORS

SMART SENIORS A publication of the Office of the Attorney General of the State of New York Andrew M. Cuomo Attorney General Dear New Yorker: I hope this brochure will help you protect your health, safety and wellbeing and provide you with information about how my office can help you. As New York’s Chief Law Enforcement Officer, I am committed to bringing to justice those who defraud, exploit and abuse New York’s senior citizens. From deceptive prescription drug plans to elder abuse in nursing homes, from phony sweepstakes to bogus charities, from home improvement to internet scams – these crimes not only rob you of your hard-earned savings, but also may jeopardize your health and dignity. The best way to fight these crimes is to join forces by creating partnerships between law enforcement and seniors. To prevent financial and physical exploitation, my office is working on Triads, a community-based crime prevention program designed to protect seniors. With senior advocates, we are enforcing quality and safety standards in nursing homes. Hand-in-hand with other community groups, we are raising awareness about telemarketing schemes and illegal home equity loans. Most importantly, you can stop scam artists before they strike. This brochure informs you of your rights under state law, and lays out the steps you can take to protect your health and assets. The many components of my office work together to fulfill our primary mission– protecting and defending the rights of all of New Yorkers. And, my Elder Task Force is committed to developing initiatives, policy and legislation on your behalf. I hope you will take advantage of all of the services we offer. If you have any complaints, questions or concerns, I encourage you to contact my office. We are here to serve you. Sincerely, ANDREW M. CUOMO 1 TABLE OF CONTENTS Guard Against Scams Introduction .....................................................................................................................3 Telemarketing: Hang Up on Scam Artists ......................................................................4 Mail Order: Shop Wisely ................................................................................................6 Door-to-Door Sales: What to Do When the Bell Rings ..................................................7 Sweepstakes: Say No to “You Have Won” Mail. .......................................................... 8 Home Improvements: Crack Down on Fly-By-Night Operators ....................................9 Predatory Lending: Be Wary of Illegal Home-Loan Scammers ...................................11 Privacy: Guard Against Identity Theft ..........................................................................13 Bogus Charities: Giving is Laudable but Watch for Scams ..........................................14 Market Watch: Protect Your Savings............................................................................16 Protect Your Health Introduction ...................................................................................................................18 Medicare: Watch Out for HMO Slammers ...................................................................18 Health Discount Cards: Rx for Wasting Money?..........................................................20 Medical Equipment: Buy Hearing Aids Wisely............................................................22 Medical Equipment: Warnings About Emergency Response System Scams ...............24 Planning in Advance .....................................................................................................25 Prevent Elder Abuse Introduction ...................................................................................................................27 Physical Abuse: Prosecuting Patient Abusers ...............................................................27 Rights of Senior Crime Victims ....................................................................................29 Contact the Attorney General’s Office Directory........................................................................................................................31 2 GUARD AGAINST SCAMS INTRODUCTION People over the age of 65 make up almost 13 percent of the United States population but represent 30 percent of scam victims. Often, it is hard to spot fraud as it is happening. And, the economic consequences can be devastating. Many seniors in New York live on fixed pensions or depend solely on Social Security for their income. This section identifies common scams that target New York seniors, informs you of your rights and protections under state law, and describes the steps you can take to protect yourself. 3 TELEMARKETING : HANG UP ON SCAM ARTISTS When a seventy-five-year old Brooklyn resident received a call from an excited salesperson offering a credit card at a low interest rate, he was so pleased that a credit card company finally made him an offer, that he immediately agreed to pay the “required” $200 advance fee. But a few weeks later, instead of a credit card, he received a catalogue offering overpriced merchandise, a credit repair manual, and credit card applications. The Brooklyn senior was not the only victim of this telemarketing fraud. Hundreds of New Yorkers, mostly seniors, were lured into paying $200 for a credit card that never arrived. Attorney General Eliot Spitzer’s Consumer Frauds and Protection Bureau took action against the three telemarketing firms that called from Montreal, Canada, and falsely promised easy credit to financially-strapped New Yorkers. The office obtained refunds for the consumers. And, the court ordered these companies to post a bond before conducting business again in New York. This is one example of telemarketing fraud, one of the fastest growing scams against seniors. Every year, seniors lose thousands of dollars responding to telemarketing calls selling a variety of products, worthless services, and overvalued or risky investments. It is a $40 billion a year business for scam artists who often use high-pressure sales tactics and make offers on the phone that can sound too good to be true. The most common scams involve: • advance fee loans • prizes/sweepstakes • business opportunities • real estate • credit card offers • stocks and bonds • magazine sales • travel and vacations • pay-per-call services • work-at-home schemes • foreign currencies & lotteries 4 If a salesperson on the other end of the phone offers you products or services that sound too good to be true, be skeptical. Here are some tips to help you avoid scams: • Never disclose your credit card, bank account or Social Security numbers to someone who contacts you by telephone or Internet; • Ask detailed questions about the offered product/service, the total price, the delivery date, the return and cancellation policy, and the warranty terms; • Ask the caller to send you more information through the mail. Any reputable company will mail information about its products or services. If a telemarketer is unwilling to provide you with specifics on the phone or through the mail, be suspicious; • Do research on the company. Check the company’s track record with your local Better Business Bureau; • Resist pressure to send payment via private courier, wire transmission or overnight delivery. These tactics sometimes prevent you from changing your mind; • Pay with a credit card since Federal law protects consumers from paying for charges on their accounts when they have not received the ordered merchandise. You have the right to contest such a charge with your credit card company; • Call 1-888-5OPT-OUT to have your name removed from consumer lists provided to telemarketers by credit reporting agencies; and • Take your time in making decisions. Remember, they called you. Don’t be afraid to say no, or hang up. Remember, Federal law requires telemarketers to: • Limit their calling hours to between 8 a.m. and 9 p.m.; • Tell consumers that they are trying to sell something; • Identify the actual seller; and • Disclose the nature of the products or services for sale, their costs, and any delivery restrictions before asking any consumer for money. 5 How to Tell Telemarketers “Do Not Call” Register with the Do Not Call Telemarketing registry by calling 1-86-NO CALL-NY or via the Internet at http://www.consumer.state.ny.us. Once your name appears on the list, telemarketers have 30 days to remove your name from their telemarketing lists. Entities exempt from this law are: charitable organizations, political parties, companies with which you have a prior business relationship, and telemarketers who arrange for a face-to-face meeting before accepting payment. If you receive a call that you think is in violation of the law, take note of: • The date and time of the call; • The telephone number if you have caller ID; • Name of the company which must be stated at the beginning of every call; • Name and address of the telemarketer; and • The product or service. Send this information to Consumer Protection Board, Corning Tower, Empire State Plaza, Albany, NY 12223, which can impose penalties for violations of the law. Changing Your Mind Under New York law, you have three business days to cancel your telephone purchase when the purchase price exceeds $25. The telemarketer must give you notice of your cancellation rights. MAIL ORDER: SHOP WISELY Many consumers, especially seniors, shop by mail. It can be a convenient way to shop. To prevent problems, consider these tips before placing your next order: • Never send cash through the mail; • Retain a copy of your order form; • Call the mail order company immediately if you have questions about the product, warranty, return policy or delivery schedule; • Refuse damaged or spoiled merchandise and complain about or cancel any order in writing; and 6 • Contact the Attorney General’s Consumer Frauds and Protection Bureau by Calling 1-800-771-7755, option 2, if you suspect fraud or misrepresentation by a mail order company. Federal and state laws provide important protections covering shipping deadlines, delay notices, cancellation rights, and refunds. Mail order companies must: • Ship your order within the time promised in advertisements or, if no time is specified, within 30 days of receiving a completed order; • If delayed, notify you of the new shipping date and permit you to cancel for a full refund. (If you do not respond, sellers can presume you have agreed to a delay of up to 30 days); and • Provide a full refund, if due to the delay, you no longer want the product. If you receive unordered merchandise, you do not have to return or pay for the item. DOOR-TO-DOOR SALES: WHAT TO DO WHEN THE DOOR BELL RINGS Unscrupulous door-to-door sellers often target seniors who are likely to be home. If you are contacted by a sales representative, follow these tips: • Always ask for identification; • Do not feel pressured to allow a salesperson into your home; • Ask questions before you sign the contract; and • Review the terms of the sales contract or receipt. Check for the refund policy and your right to cancel the contract within three business days. 7 SWEEPSTAKES: SAY NO TO “YOU HAVE WON” MAIL “This is the special invitation we told you to look out for...the one that guarantees you’ll win a cash prize of up to $1,000,000! It’s true! As a president’s club member, with your timely response this time you’ll be taking your place on the Cash Winners List because, (your name here), you’re guaranteed to win.” The leading sweepstakes marketers bombarded thousands of New Yorkers with mailings like this one, suggesting they were about to win or had just won a multimillion-dollar sweepstakes. The solicitations also suggested that ordering magazines, videotapes, household gadgets and other items would increase the chances of winning. Many New Yorkers, a majority of them seniors, responded and spent thousands of dollars, which they could ill afford, on merchandise they did not need. All they received in return were broken promises and dashed hopes. “I purchased magazines and submitted my entry because I was promised by the contest manager that I would be a winner,” one senior told the Attorney General’s Office. “When I received the slip telling me to be home to receive the check I did not even go to church,” wrote another senior on a fixed income. Receiving thousands of these complaints, the Attorney General’s Consumer Frauds and Protection Bureau launched a multi-state investigation that led to agreements with three sweepstakes companies. Millions of dollars were routed to seniors as refunds. If you receive an “official looking” prize notice in the mail or a salesperson on the other end of the phone claims you have won a prize…Watch out. Be suspicious of any sweepstakes solicitation that asks you to send money to cover shipping and handling costs or to provide a credit card number as a condition of receiving your prize. Most important, New York State law prohibits: • Claims that you are a winner unless you have actually won a prize; • Requirements that you buy something to enter the contest or to receive future sweepstakes mailings; 8 • The mailing of fake checks that do not clearly state that they are non-negotiable and have no cash value; and • Use of seals, names or terms that imply government affiliation or endorsement. And, remember: • Sweepstakes are free; • Buying merchandise will not improve your chances of winning; • Before you get excited about having won the sweepstakes, read the entire solicitation. If your prize notice tells you that you are a “guaranteed winner,” there is usually a qualifying statement indicating that you are only the “winner” if you have and return the winning number; and • Bona fide contests clearly disclose the terms, rules, entry procedures, and odds of winning. HOME IMPROVEMENT : CRACK DOWN ON In an unsolicited visit to 81-year-old Mrs. S, a Rochester contractor presented a pail of soot that he claimed to have collected from her chimney. Heeding the contractor’s warning that her home needed urgent repair, Mrs. S paid $2,600 immediately. The contractor began work, subsequently demanding another $1,625. When Mrs. S’s niece learned of the ongoing work, she reminded her aunt that the chimney was only six years old and had passed an annual inspection. Mrs. S’s complaint and 29 other complaints from Rochester residents resulted in the Attorney General’s Office suing the contractor who ultimately paid $80,000 to his victims. 9 Complaints against unscrupulous contractors have triggered several investigations and prosecutions by the Attorney General’s Office. As a result, the contractors have paid restitution to their victims and ended their deceptive practices. Each year, home improvement contracting fraud ranks among the top five most common complaints received by the Attorney General’s Office. The complaints involve, among other things, shoddy workmanship, deceptive pricing, and failure to honor warranties or make refunds. To guard against home improvement scams: • Watch for contractors who come to your home unsolicited claiming that your home needs expensive repair work for damage that you never noticed. Common approaches involve work on your chimney or driveway. These contractors often offer a special “deal” because they have material left over from another job in your neighborhood; • Never agree to have work done on the spot. Determine what you want done and seek qualified contractors; • Get at least two written estimates from reputable contractors that include specific information about the materials and services provided for the job; • Check references by contacting the Better Business Bureau, local licensing authorities, previous customers, banks and suppliers; • Do not pay the full amount up front or other unreasonable advance sums. Negotiate a payment schedule tied to the completion of the job and pay by check. Do not pay with cash; • Get any promises in writing and make sure the project is thoroughly described in your contract. If you can, ask a lawyer to review the terms of the written contract before you sign; and • Don’t be bullied or pressured. Call the police and get a license plate number if a door-to-door contractor won’t take “no” for an answer. Remember, under New York State law: • Home improvement contractors are required to give you a written contract in advance on jobs priced above $500. The contract must contain: the contractor’s name, address and telephone number; a description of the work to be performed, the materials to be used, and the price; and approximate starting and completion dates. 10 • You have three days to cancel a home improvement contract. Cancellations must be in writing; • Home improvement contractors are required to deposit all payments in an escrow account (in a place known to you) or post a bond; • You can sue for damages, plus a $500 penalty and attorney’s fees, if the contractor uses fraudulent written statements to get you to sign the contract; and • Some counties require contractors to be licensed and maintain a fund to reimburse homeowners who have been defrauded. For more information, contact your town or county clerk’s office or local consumer affairs agency. PREDATORY LENDING: BE WARY OF ILLEGAL HOME-LOAN SCAMMERS A mortgage company promised easy home loans to hundreds of consumers, mostly elderly African-American Brooklyn and Queens residents. They borrowed heavily only to discover that they had no ability to pay the exorbitant interest rate the company was charging. The consequences were devastating: many seniors and families paid more than half of their pre-tax monthly income to the lender. Some were driven into poverty. Others could not keep up with the payments and lost their homes in foreclosures. The Attorney General’s Civil Rights Bureau launched an indepth investigation that led to the company discontinuing its unscrupulous lending practices and paying $6 million to hundreds of its victims. The company described above was a subprime home equity lender. These lenders make loans to homeowners who do not have access to traditional bank loans or credit lines because of where they live, their income or credit histories. Each year, seniors and minorities, many with bad credit histories, are targeted and pressured by some unscrupulous lenders and brokers to get high-interest and fee-padded loans. The loans, which provide little or no financial benefit to the consumer, are usually secured by a mortgage on their home. The practice is known as predatory lending. This thriving $20 billion dollar subprime lending industry, while not in itself illegal, can involve unscrupulous tactics. 11 To protect yourself and your finances be wary of: • Loans offered through door-to-door sales or telemarketing solicitations; • Home improvement scams in which a mortgage broker is offering to assist with a loan for repairs that is really a new mortgage on your home; • Pressure tactics that encourage you to rapidly sign a stack of documents you have never seen or read; • Consolidation of all debts appearing on your credit report into your mortgage payment; and • A broker discouraging you from obtaining an attorney. Here are some other tips to think about: • Be suspicious of lenders or brokers who guarantee loan approval regardless of your credit history or rating; • Shop around! Interest rates and fees vary widely. Don’t assume you will not qualify for a loan from a traditional lender like a bank or a credit union; • Avoid lenders who seek up-front fees to cover the first loan payment and other expenses because you may never get the loan after you have paid these fees; • Ask about fees and “points” before applying for a loan. The interest rate is not the only important term of a loan; • Watch out for “hidden” terms, excessively high fees or changes in terms and conditions such as prepayment penalties and balloon payments; • Check that the lender and the broker are licensed by the State Banking Department by calling (800) 5223330; • Contact a non-profit credit counseling agency for assistance in determining whether you can afford your loan, especially the monthly payments. As a general rule, responsible lenders look for mortgage payments to total no more than 29% of your total gross income; • Check that you have received, read and understood all required disclosure documents before closing. At closing, make sure the loan terms have not changed from what you were told before and that there are no additional fees; and, • Consult an attorney before signing anything! 12 PRIVACY: GUARD AGAINST IDENTITY THEFT Robert Reeves, an Auburn resident, stole personal identifying information of several New Yorkers, including seniors, and then used it to get jobs, open credit card and bank accounts, and buy cars worth thousands of dollars. Reeves’ unsuspecting victims found themselves dealing with demanding calls from collection agencies, bounced checks and scarred credit records. The Attorney General’s Office prosecuted Reeves. He was convicted, ordered to serve prison time, and pay restitution to his victims. Identity theft is one of the fastest growing consumer scams in America. Some estimate that between 500,000 and 700,000 people – or one per minute – will have their identities stolen this year. Identity thieves range from old-fashioned pickpockets to sophisticated theft rings with high-tech equipment. Typically, an identity thief steals your Social Security number, mother’s maiden name, and date of birth and uses this information to obtain credit or bank accounts in your name, or otherwise commit a crime. Limiting access to your information can reduce the risk of identity theft. Follow these steps to better protect your private data: • Be careful about disclosing personal information such as your mother’s maiden name, your Social Security number, and date of birth. Do not use this information for PIN numbers or passwords; • Ask how your data will be used and who will have access to it. You should ask if you can restrict disclosure; • Don’t mail personal checks in envelopes from a home mailbox. If stolen, checks can provide valuable information to a thief or be altered and cashed; • When you order new checks, remove extraneous information such as your middle name, phone number, Social Security number or driver’s license number; • Before discarding credit card convenience checks, preapproved credit offers, bank statements and important bills, tear them into small pieces or shred them. If “dumpster divers” find them, they can cash the checks or order credit cards in your name; • Carefully review records, including credit card and mortgage statements for unauthorized charges or fraudulent use. Check your credit report annually for inaccuracies and fraudulent activity; 13 • Don’t disclose your credit card number or other personal identifying information over the phone unless you know with whom you’re doing business and how your information will be used; • Sign your credit cards as soon as you receive them. Cancel inactive accounts; • Shop smartly online. Before buying, make sure that you are familiar with the company or seller, including its privacy policy. Disclose only necessary personal information, and opt-out of possible information sharing; • Get an “attitude.” Do not open e-mail from people you don’t know. Delete it. Merely opening an e-mail can sometimes send your information back to a fly-bynight company; and •If you feel uncomfortable in any online transaction, look for a customer service number on the website and complete the transaction by phone. BOGUS CHARITIES: GIVING IS LAUDABLE A representative of the S.D. Police Officers Association called 79-year-old Mr. B, and asked for a contribution to benefit the local police department. Mr. B refused to make a donation and hung up. The solicitor called back immediately and demanded a credit card contribution. Suspicious of the solicitor’s high-pressure tactics, Mr. B contacted his local police department and learned that no such group existed. Every day, police and firefighters risk their lives to make our communities safer. To show support, many seniors consider making a donation when a fundraiser says that he or she is calling on behalf of a fire or police service organization. 14 If you are asked to give to a group representing the police or firefighters: • Check the identity and legitimacy of the group asking for the contribution by contacting your local police or fire department; and • Be wary of a solicitor who uses coercive tactics or who promises that your contribution will entitle you to better police protection or special privileges. This is illegal. New Yorkers donate more than $10 billion to charity. Older New Yorkers are especially generous. While most charities are honest, some employ dubious solicitation tactics. Before donating money to a charity online, by mail, telephone or in-person solicitations, watch out for the following: • Be alert to groups using names that closely resemble those of well-known charities; • If you do not recognize the charity, it could be a fraud. A legitimate charity welcomes background checks on its operations. Verify the organization by asking for its exact name and phone number, especially if donating online; • Find out the planned uses for the money to be donated. Will proceeds directly benefit those in need? What portion of the contribution will go toward the charitable purpose and what portion will be spent on fundraising and administrative costs? • Be wary of appeals that are long on emotion and short on descriptions about providing help to those in need; • Don’t succumb to high-pressure tactics and demands for an immediate decision; • Before making a donation online, look at the organization’s URL in the browser window. If the domain name of the URL is hidden, is unfamiliar or is not the same as the link’s text, the request may be a scam; • Never give credit card or Social Security numbers to a telephone solicitor; • Do not give cash. Write a check in the name of the charity, not the individual fundraiser, and get a receipt; and; • Check with the Attorney General’s Charities Bureau to determine whether the organization is registered. 15 Pennies for Charity – Where Your Money Goes The Attorney General’s Charities Bureau regulates the conduct of charitable organizations to ensure that donated funds are used properly and contributors are protected from unscrupulous fundraisers. Most charities, except religious and certain educational organizations, are required to file annual financial statements with the Attorney General’s Office. These filings disclose the amount of money a charity raises and its expenditures on salaries and fundraising. You can obtain a copy of a charity’s financial disclosures at the Attorney General’s Charities Bureau in New York City or by mail. A free copy of the Attorney General’s annual report on telemarketing campaigns for charity – Pennies for Charity-Where your Money Goes is available at www.oag.state.ny.us/ charities/charities.html. The report’s data includes the total amount contributed to a charity and the amount received by the charity for which the telemarketing fundraising campaign was conducted. If you suspect fraud by a charity or a fundraiser, you should contact the Attorney General’s Charities Bureau at (212) 416-8400. MARKET WATCH: PROTECT YOUR SAVINGS Over the past years, more and more New Yorkers have been investing in the securities market hoping to earn higher returns. Three out of four people over 65 years of age receive at least 25 percent of their income from investments. Securities, such as stocks, mutual funds and other investments are sometimes higher-yielding – and also higher risk. Unfortunately, that has made many senior citizens vulnerable to con men and fast-talking brokers who are far too eager to deprive investors of their life savings. 16 What to watch for: In order to protect yourself and your savings, follow these tips before investing: • Be wary of unsolicited phone calls and letters; • Always demand written information – and read it carefully; • Be suspicious of “insider information,” “hot tips,” or “rumors;” • Never be afraid to ask questions or tell someone that you don’t understand; • Don’t give in to high-pressure sales tactics; • Don’t believe promises of doubling or tripling your money in a short time; • Deal only with established brokers; • Read the fine print on contracts and prospectuses; • When in doubt about an investment, don’t make a commitment before you feel comfortable. It’s better to lose an “opportunity” than to act hastily and lose the money you have worked so hard to save; • Check with the Attorney General’s Investment Protection Bureau for information about brokers. Investment Protection The Attorney General’s Investment Protection Bureau regulates securities dealers and brokers. In addition, the Attorney General reviews franchise offers and certain other types of investments to assure that all material facts are disclosed to potential investors before they make a particular investment. Every licensed broker is required to register with the Attorney General’s Office. In addition, the Attorney General keeps track of all disciplinary actions taken against brokers by other agencies, including the federal Securities and Exchange Commission. Immediately report any suspicious or fraudulent activity to the Attorney General’s Investment Protection Bureau, located in New York City. For more information, call the Attorney General’s Consumer Hotline at (800) 771-7755. 17 PROTECT YOUR HEALTH INTRODUCTION People 65 and older – those eligible for Medicare – constitute 12.4 percent of the American population. But they account for 34 percent of all prescriptions filled and spend 42 percent of the money spent on prescriptions. While Medicare foots the bill for hospital stays, visits to the doctor and laboratory tests, most seniors pay out of pocket for deductibles, coinsurance, supplemental insurance and prescriptions. Nearly one-third of people with Medicare have no prescription coverage. That is why many seniors buy private Medicare supplemental health insurance, commonly known as Medigap coverage, or join an HMO. Finding the right product or service to fit your health needs can be confusing. This section alerts you to the pitfalls you may encounter as you consider buying certain health care services, and describes the steps you can take to protect yourself from health care scams. MEDICARE: WATCH OUT FOR HMO SLAMMERS When a door-to-door salesperson from a Manhattan-based HMO visited seventy-six year-old Mr. B at home, he agreed to sign up for what he thought was a prescription drug plan. A few months later, Medicare denied payment for his physician’s bill on the basis that Mr. B was a Medicare HMO member. Mr. B’s case along with several other complaints filed with the Attorney General’s Health Care Bureau triggered an in-depth investigation. The Health Care Bureau staff discovered that the Manhattan-based HMO had been enrolling seniors in its Medicare HMO plan without their knowledge or consent, a practice known as “HMO slamming”. The HMO signed an agreement with the Attorney General promising to reform its marketing and enrollment practices. Medicare fee-for-service, sometimes known as original or traditional Medicare, is the way most seniors receive their Medicare health benefits. However, some seniors find themselves enrolled in an HMO without their consent or without understanding that they have switched into a Medicare HMO. The HMO may not have explained that a Medicare HMO member can only go to a limited number of doctors and hospitals in the HMO’s “network” and only see specialists with referrals from a primary care physician. 18 To Prevent HMO Slamming: To prevent being enrolled in a Medicare HMO without your knowledge or consent: • Never feel pressured to “act now” or sign something immediately. Ask the HMO sales representative to give or mail you written information about the plan and review it later with friends or family members; • Be wary of salespeople who ask you to sign a form to “show that I met my quota of people to talk to” because these signatures have been used to enroll people in HMOs illegally. If you are enrolled in a Medicare HMO without your knowledge or consent: • Seek retroactive disenrollment by submitting a request to the HMO or to the Centers for Medicaid and Medicare Services (CMS) Regional Office. CMS will review your request and decide whether to grant it. Or call the Attorney General’s Health Care Bureau at 1-800-771-7755, option 3; • If you are granted retroactive disenrollment, your enrollment in the Medicare HMO is “erased,” as if you never joined in the first place. Claims for the care you received as a Medicare HMO member would then be submitted to original Medicare. 19 HEALTH DISCOUNT CARDS: RX FOR WASTING MONEY? FREE AT LAST...NO MONTHLY CHARGES, NO PREMIUMS, NO CO-PAYMENTS, NO LIMITS OR MAXIMUMS, FREE... SAVE UP TO 80% ON ALL HEALTHCARE AND Rx COSTS Over 40,000 healthcare providers, more than 100 boardcertified specialties and 150 Metro area hospitals to choose from. Plus, all major chain drug stores and pharmacies nationwide... SIGN UP FOR (NAME OF DISCOUNT CARD) AND START SAVING You may have seen ads for health or prescription drug discount cards. Be wary. Despite confusing advertising claims, these discount cards do not provide health insurance. Over the last two years, the number of private companies marketing such discount cards has increased. New Yorkers, especially seniors, are being bombarded with direct mail or telephone solicitations urging them to sign up for discount cards. Virtually all of the companies claim to offer huge breaks on prescription drugs, dentist and doctor office visits, hospital and emergency room visits, eye glasses, hearing aids – even veterinary care. At a time when consumers are looking to save money on their heath care bills, these offers may sound too good to pass up. Be careful: some health discount cards promise more than they can deliver, some are worthless, and some are outright frauds. A company may sign you up for a “free” trial period, only to deduct a discount card membership fee from your credit card or bank account. Or, you may be unable to find 20 doctors or hospitals participating in the discount card plan. Or, providers listed by the company may not accept its card. Often, you may discover that you can never get the promised discounts. Follow these tips before signing up for a health care discount card program: • Shop around – the cost of a discount card could range from $0 or a nominal fee to $120 for the same discounts on a similar range of health services; • Never pay large sums in advance for a discount card; • Never sign up for a prescription or health discount card without confirming that your pharmacy or health care providers accept it; • Remember, senior citizens often receive discounted prices from many pharmacies and other health providers without a discount card. Always check with them first; • Carefully read the fine print of your agreement with the discount card plan. The discount card companies doing business in New York are unregulated and you cannot rely on state mandated benefits or protections; • Ask detailed questions such as: Who do I call if I have a health care problem? What guarantees do I have as part of this plan? For example, does the plan guarantee access to its providers? Is there a guarantee that I will receive the minimum discount promised for the services? Will I get a regular statement outlining my savings? Will services have to be preauthorized? Does the plan have a 24-hour help line? If not, what is the number and hours of the help line? - • Never give your credit card number or bank account information unless you are sure about signing up for the discount card plan you have selected. 21 MEDICAL EQUIPMENT: BUY HEARING AIDS WISELY Mr. E, a 97-year-old man, spent $1,170 for a hearing aid from a dealer who visited him while he was in hospital. When the nurses at the hospital could not operate it, he immediately notified the company. In spite of repeated phone calls, the company refused to give him a refund. He turned to the Attorney General’s Office for help. An investigation discovered that the company had misled hundreds of consumers into buying faulty hearing aids. The Attorney General took legal action against the company, stopped the deceptive practices and obtained refunds for hundreds of seniors. Here are some tips on making smart hearing aid purchases: • It is always wise to have a doctor test your hearing so you can find out the cause of your hearing loss and your specific needs; • Get a referral from your doctor or friends who were satisfied with the services received from a hearing aid dealer; and • Select a seller who promptly responds to your concerns and works with you to resolve fitting and volume adjustment problems. Look for a seller who will teach you how to use the device and be available to service it. New York State law requires hearing aid dealers to: • Register with the New York Secretary of State; • Sell you a hearing aid only if you have been examined by a physician licensed in New York State whose practice is limited to problems of ears, pharynx, and larynx, unless you sign a statement waiving an examination by a physician; • Provide a written agreement, specifying whether the hearing aid is new, used or reconditioned, the terms of the warranty, and your right to a 45-day money-back guarantee; • Repair your hearing aid and provide necessary service; and • Refrain from selling hearing aids through the mail, door-to-door without your prior consent, or over the phone unless the call is initiated by you or where you have been tested by that dealer within the last 30 days. 22 And, remember: Under New York law, you have up to a year to revoke a hearing aid purchase, if a medical professional certifies in writing that, at the time of purchase, the hearing aid provided “no benefit” for your specific medical condition. The dealer must provide a full and complete refund within ten days of being notified in writing of your decision to revoke the purchase. 23 MEDICAL EQUIPMENT: WARNINGS ABOUT EMERGENCY RESPONSE SYSTEM SCAMS In an effort to maintain independence and gain reassurance, many seniors and their families are shopping for personal emergency response systems – electronic signaling devices that call for help in an emergency. Such systems can be purchased or leased. Unfortunately, some unscrupulous sellers and manufacturers pressure unsuspecting consumers into buying overpriced, inferior products. Before purchasing a personal emergency response system, take note of the following: • The seller must give you a receipt or copy of an agreement that sets forth your right to cancel the purchase without penalty within seven business days of the sale or lease; • You may cancel the agreement with 30-days written notice if you are, or will be within 30 days, entering a nursing home or other health-related facility for a permanent stay or extended stay of at least two months; and •The seller must disclose its refund policy. If not, the seller may be liable for a cash refund or credit of the total price. 24 PLANNING IN ADVANCE Ms. G, an 83-year-old Rochester resident, was near death in a local hospital when the doctor asked her family members if she had a living will or a health care proxy providing directions about end-of-life care. She did not. No one likes to talk or think about getting sick. All too often seniors think family members know what they want in case of an illness or accident. This is not always the case. Some advance planning can save your loved ones a great deal of stress when the time comes and make sure that your wishes are followed. Making Your Health Care Wishes Known: Advance Directives New York law provides a number of ways to ensure that your medical treatment preferences are followed if you are suddenly unable to communicate your wishes because of an unpredictable event. You should discuss your health care preferences with your physician, your relatives, and any health care agent you appoint so that they become familiar with your wishes. Health Care Proxy • A health care proxy is a written document that allows you to appoint someone to make decisions regarding the use, withholding or withdrawal of life-prolonging treatment when you are unable to make such decisions, as determined by a physician. You can get a copy of the Health Care Proxy form from your health care provider; • Without a health care proxy, your doctor may be required to provide you with medical treatment that you may have refused if you were able to do so. For example, a doctor may be required to provide you with artificial nutrition and hydration, or a respirator, even though you are in a coma, with no hope of recovery or are terminally ill; and •A health care proxy can be revoked orally. While competent, you have the right to sign a new health care proxy at any time. Living Wills • If you do not wish to appoint someone to make decisions for you, you can give specific written instructions about treatment in a document called a living will; • A living will is a written statement regarding the use, withholding, or withdrawal of life-prolonging treatment and becomes effective when you are unable to make decisions; 25 • A living will usually sets out very specific situations and lets you set forth your decisions about health care treatment in those situations; and • Medical situations are rarely “cut and dry.” If you consider this option, make sure you discuss the situations listed with a trusted doctor. Do Not Resuscitate (DNR) Order • A DNR is an advance directive that orders doctors, nurses and other health care professionals not to perform emergency procedures such as CPR (cardiopulmonary resuscitation); • You can obtain a Hospital DNR Order or ask your physician to issue a Non-hospital DNR Order. The Nonhospital DNR Order directs emergency medical personnel not to perform CPR if you suffer cardiac or respiratory arrest; and • If you lack capacity and you have not appointed a health care agent through a Health Care Proxy, a surrogate may obtain a DNR on your behalf but only if the surrogate can show such an order would be consistent with your known wishes and religious and moral beliefs or, if they are not known, your best interests. In addition, the attending physician and a concurrence physician must make certain medical determinations. A surrogate can be a guardian, spouse, adult child, parent, adult sibling or close friend. Absent an available, willing, and competent surrogate, a physician or hospital can seek a DNR from a court under certain circumstances. Planning in Advance for Matters Other than Health Care: Powers of Attorney New York State law enables you to designate another person to make property, financial, and other legal decisions on your behalf through a “Power of Attorney”. You can create “Nondurable,” “Durable,” or “Springing” Powers of Attorney depending upon your particular need for representation. • A Nondurable Power of Attorney allows you, the Principal, to appoint an Agent or Attorney-in-Fact to act on your behalf in a specific transaction or during a specific period of time, for example, while you are traveling away from home. • A Durable Power of Attorney authorizes another person to act for you immediately upon its execution and lasts until revocation by you or upon your death; this power continues when you are mentally or physically incapacitated. • A Springing Power of Attorney becomes effective at a future time upon an event identified by you and lasts until your death or revocation by a court. 26 To protect yourself against fraud while making these critical decisions follow these guidelines: • Take time when making any decision about your estate or health; • Do not agree to contract for any legal service from someone selling door-to-door or over the phone; and • Avoid dealing with anyone but a trusted professional. Contact a professional accountant, estate planning attorney, banker, or financial advisor for advice before making decisions. PREVENT ELDER ABUSE INTRODUCTION Elder abuse refers to physical and psychological mistreatment, financial exploitation, neglect, confinement, abandonment, hazardous living conditions, intimidation, and sexual abuse involving senior citizens. The abuser may be a caretaker, nursing home or hospital worker, a visitor, or even a family member. One in 20 older Americans nationwide is a victim of elder abuse each year, for a total exceeding 1.5 million. Elder abuse is one of the most under-reported crimes, still largely hidden by a shroud of secrecy. PHYSICAL ABUSE: PROSECUTING PATIENTABUSERS Patricia Pawlak, 30, a certified nurse’s aide at a Niagara county nursing home is serving one year in prison for slapping her 81-year-old Alzheimer’s patient in the face. Arthur Wallace, a certified nurse’s aide at an Oneida nursing home was arrested for repeatedly raping a 92-year-old female patient during a two-period. He was convicted in May 2000 and sentenced to 25 to 50 years in state prison. The aide’s criminal record 27 revealed a court martial from the U.S. Army for “lewd and lascivious” contact with a minor and a six month sentence of hard labor at a federal prison for having sexual contact with a 3-year-old girl. These are but two examples of the incidents resolved by the Attorney General’s Medicaid Fraud Control Unit (MFCU), dedicated exclusively to investigating and prosecuting health care crime including cases of patient abuse, neglect and exploitation in nursing homes and adult homes in New York State. In 2001, MFCU logged 1,500 complaints of patient abuse statewide. While the vast majority of residential care is good, every New Yorker with a loved one in one of these facilities should watch for signs of abuse and neglect. • Report any evidence of intentional injury to a patient to nursing home staff immediately; • Evidence of injury may include: unexplained facial injuries; unexplained fractures, or trauma to the head, jaw, face or neck; and unexplained bruising or skin trauma, such as “grip” bruising on the inside arm or “footprint” bruising on the arms and legs; • Heed a resident’s unusual anxieties when a certain staff member enters his or her room; • Take note of a resident’s unexplained or sudden loss of weight, appetite, mobility, or interest in favorite activities; • Pay attention to an individual’s dehydrated or soiled appearance; and • Check any decubitus ulcer (bedsore) that fails to heal or becomes severe. 28 In conducting background checks on health care workers arrested for abuse or violence against residents of nursing homes, the Attorney General’s Medicaid Fraud Control Unit has found that 25% of the abusers have had prior arrests for crimes, including the sale of drugs, sexual abuse and felony assault. To protect nursing home residents and home-bound elderly from violent and abusive health care workers, the Attorney General proposed legislation that would require all new nurse’s aides and home care workers to undergo criminal background checks before they are hired. Adult protective services agencies also have the responsibility to protect and provide services to vulnerable incapacitated or disabled adults. They can receive and investigate reports of suspected abuse, neglect and exploitation and provide follow up services. Nationally, nearly 70 percent of Adult Protective Service agencies’ annual caseloads involve elder abuse. In New York, Adult Protective Services can be accessed by calling 800-342-3009. In addition to contacting Adult Protective Services in your area, a family member or friend can also encourage victims to file for an order of protection when appropriate. Family Court and Criminal Court can order the offender to stop the abusive behavior and can arrange for needed services to be brought into the home. Social workers can help establish safety plans and explore alternative living arrangements. RIGHTS OF SENIOR CRIME VICTIMS Too often, elderly individuals are the victims of violent or property-related crimes. Under New York State law, you have specific rights in the criminal justice system including the following key provisions: Information • Crime victims should receive information about victim services and programs, including hotlines, domestic violence shelters, and rape crisis centers. • Victims should receive information about their role in the criminal justice process. • Crime victims are entitled to a copy of the police report relating to the crime. Consultation •Crime victims and their families have the right to consult with the prosecutor, to provide their views about the disposition of the case, the defendant’s release, and sentencing including restitution. 29 Notification • Victims who provide prosecutors with a current address and telephone number may be notified of court proceedings and other information relating to their case. • Crime victims can learn information about custody and release data on prison inmates by calling the Department of Correctional Services (DOCS) toll-free Victim Information and Notification Everyday number at 1-888-VINE4NY. Victim Involvement • When a defendant has committed a felony, victims or their families have the right to address the court on any matter relevant to sentencing and restitution. • A judge cannot sentence a defendant convicted of any crime to 90 days or more or to a sentence of probation without first receiving a pre-sentence investigation report prepared by the Department of Probation. Where appropriate, this report may contain a Victim Impact Statement with information about the victim’s version of the offense, the extent of injury or economic loss, the actual out-ofpocket loss, and the views of the victim relating to disposition, including the amount of restitution and reparation. • A crime victim or a victim’s representative is entitled to submit a statement to the Parole Board. Making Victims Whole: Crime Victims Board and Victim Compensation • The NYS Crime Victims Board provides substantial financial relief to victims of crime who suffer from physical injury as a direct result of the crime. Seniors, disabled persons, and others who have not suffered physical injury as a direct result of the crime also may be entitled to receive compensation. • A victim’s property held for evidentiary purposes must be promptly returned, unless there is a compelling reason relating to trial for retaining it. • Crime victims, who suffer financially as a result of the crime, may request law enforcement agencies to explain to creditors about the nature of the crime as well as the extent of loss or injury suffered that has prevented victims from meeting their financial obligations. 30 CONTACT THE ATTORNEY GENERAL’S OFFICE DIRECTORY • Information & Complaint Line 1-800-771-7755 -Press or Say “0” to reach the Operator -Press or Say “2” for Consumer; Telecommunication; and Internet matters -Press or Say “3” for Health Care matters -Press or Say “4” for Charity; Non-Profit; and Investment Protection matters -Press or Say “5” for Civil Rights or Environmental matters -Press or Say “6” for Crime Victim matters • • Medicaid Control Fraud Unit 1-212-417-5397 For The Hearing/Voice Impaired 1-800-788-9898 REGIONAL OFFICES The Capitol Albany, New York 12224-0341 120 Broadway New York, New York 10271-0332 Binghamton Regional Office 44 Hawley Street, 17 Floor Binghamton, New York 13901-4433 Brooklyn Regional Office 55 Hanson Place Suite 1080 Brooklyn, New York 11217-1523 (718) 722-3949 31 (607) 721-8771 th (518) 474-5481 (212) 416-8345 Buffalo Regional Office Statler Towers 107 Delaware Avenue Buffalo, New York 14202-3473 Harlem Regional Office 163 West 125 Street, Room 1324 New York, New York 10027-8201 Nassau Regional Office 200 Old Country Road, Suite 460 Mineola, New York 11501-4241 Plattsburgh Regional Office 43 Durkee St. Plattsburgh, New York 12901-2818 Poughkeepsie Regional Office 235 Main Street, 3rd Floor Poughkeepsie, New York 12601-3194 Rochester Regional Office 144 Exchange Boulevard Rochester, New York 14614-2176 Suffolk Regional Office 300 Motor Parkway Hauppauge, New York 11788-5127 Syracuse Regional Office 615 Erie Boulevard West, Suite 100/102 Syracuse, New York 13204-2465 (315) 448-4800 (631) 231-2401 (585) 546-7430 (845) 485-3900 (516) 248-3302 (212) 961-4475 (716) 853-8400 (518) 562-3282 32 Utica Regional Office 207 Genese Street, Room 508 Utica, New York 13501-2812 Watertown Regional Office 317 Washington Street Watertown, New York 13601-3744 Westchester Regional Office 101 East Post Road White Plains, New York 10601-5008 (914) 422-8755 (315) 785-2444 (315) 793-2225 Attorney General’s World Wide Web Site http://www.oag.state.ny.us 33