Scammers Target Native Americans in Montana with Fake Health Care Promises

In Montana, a disturbing scam has come to light, preying on vulnerable Native Americans. Fraudsters roamed reservations, convincing people, especially those without homes, to sign up for Affordable Care Act plans. They promised free rehab treatment at fancy facilities, often in California, and even offered transportation. But once victims arrived, they faced a different reality. The scammers pressured people into signing up, almost forcing them to comply. At these fake treatment centers, victims' conditions were falsely reported as emergencies, making insurance companies pay for treatments that never happened or weren't needed. In one shocking case, over $900, 000 was billed for a single person's treatment. This scam exploited several weaknesses in the health care system. For instance, while most people can only enroll in Affordable Care Act plans during specific times, Native Americans can sign up anytime. This loophole gave scammers more opportunities to target them. Additionally, one of Montana's insurance providers covers out-of-state treatments, allowing scammers in other states to bill for care they didn't provide. The scammers also found ways around federal eligibility requirements. A recent report highlighted significant fraud risks in a program that helps lower monthly health insurance costs. The report revealed that the federal Marketplace approved coverage for nearly all fictitious applicants.Thanks to the efforts of Montana State Auditor James Brown, 80 fraudulent insurance sign-ups were canceled, recovering over $23. 3 million. His office suspects 207 total enrollments, which could amount to $54. 7 million in unjustified claims. This isn't the first time Native Americans in Montana have been targeted. In 2023, a similar Medicaid fraud scheme billed Arizona thousands of dollars for services never provided. The scam exploited a loophole in Arizona's American Indian Health Program, allowing individuals to act as treatment facilities. Brown has warned other states, especially those with large Indigenous populations, to be on the lookout for similar scams. Since the scheme occurred on tribal land, federal authorities will handle the charges. Brown's office has been in contact with the FBI and the U. S. Attorney's Office. This scam could have lasting effects on insurance coverage for Montanans. Some companies might limit out-of-state services to prevent future fraud. As Brown pointed out, when scammers bill thousands in fake enrollments, premiums rise, and families end up paying more for worse care. Montanans are advised to stay vigilant. If something sounds too good to be true, it probably is. Always double-check before signing up for any health care plans.