The Consumer Assistance Program’s (CAP) top consumer complaints of 2021 ranks health/medical concerns fourth among the primary problems reported by Vermont consumers, with issues including billing and charge disputes. While the Consumer Assistance Program provides informal mediation on medical billing disputes involving providers, there are several resources available to consumers to resolve medical billing disputes, particularly if a regulated business, such as an insurance provider is involved. In the medical billing realm, consumers have earned more protections just this January through the Federal No Surprises Act, aka the “No Surprises Act” or the “No Surprise Billing Act.”
The No Surprises Act prevents surprise medical bills and has changed how unanticipated out-of-network bills can be assessed. The intention of the act is to remove the surprise that accompanies receiving large unanticipated bills after receiving health care services. There is a lot to know and there are already a number of resources to help you understand the act and your rights more thoroughly, including information on Centers for Medicare & Medicaid Services and the U.S. Department of Health & Human Services websites.
The No Surprises Act gives some medical billing control back to the consumer.
Key information you should know about this new law:
Who does it cover?
People covered under group and individual health plans.
What does the law provide?
Protection from receiving surprise medical bills for most:
Emergency services
Non-emergency services from out-of-network providers at in-network facilities
Services from out-of-network air ambulance service providers
It…
Bans surprise billing in private insurance for most emergency care and some instances of non-emergency care.
No Surprises Statement
Requires that uninsured and self-pay patients receive key information, including overviews of anticipated costs and details about their rights.
Bans surprise bills for emergency care and requires that cost-sharing for these services–like co-pays—always be based on in-network rates, even when care is received without prior authorization.
Bans surprise bills from certain out-of-network providers if you go to an in-network hospital for a procedure; cost sharing for certain additional services during your visit will generally be based on in-network rates.
Requires providers and facilities to share with patients easy-to understand notices that explain the applicable billing protections and who patients should contact if they have concerns that a provider or facility has violated the new surprise billing protections.
Requires most providers to give a “good faith estimate” of costs before providing non-emergency care for people who do not have health insurance or pay for care on their own.
Protects against “Balance Billing” abuse. Balance billing is when a provider bills for the difference between the provider’s charge and the allowed amount.
Prohibits a preferred provider from balance billing.
Prevents air ambulance services from imposing cost-sharing greater than the in-network cost.
When might the law not apply?
While there are many protections in place, a patient may agree to balance billing for certain non-emergency situations, however this must be disclosed in writing and utilize a specific “Surprise Billing Protection Form.” By signing the form, patients agree to give up their federal consumer protections, agreeing to pay more for out-of-network care.
This notice and consent waiver for balance billing is NOT permitted for:
Emergency services
Unforeseen urgent medical needs arising when non-emergent care is furnished
Items/care related to emergency services
Diagnostic services including radiology and lab services
Out-of-network provider services when in-network providers cannot provide necessary such service
Surprise bills may continue to be issued by the following facilities:
Birthing centers
Clinics
Hospice
Addiction treatment facilities
Nursing homes
Urgent care centers (by circumstance)
What if you receive a surprise bill?
There is an independent dispute resolution process for payment disputes between plans and providers as well as new dispute resolution opportunities for uninsured and self-pay individuals.
Assistance obtaining free and lower-cost health coverage. Advice and support in solving medical billing problems, including Medicaid. Assistance deciphering health plan coverage.
As described in CAP’s blog a few years back, Navigating Health Care Can Be Tough, click the blog for even more helpful resources. Contact CAP for assistance resolving provider billing disputes.
A National Consumer Protection Week feature. “National Consumer Protection Week (NCPW) is a time to help people understand their consumer rights and avoid frauds and scams” (FTC).
Government Impersonation scams were the top fraud reported between 2014-2021, with a total reported loss of $442.21 million according to the Federal Trade Commission (FTC). In 2020, with the popularity of the Social Security Imposter scams increasing steadily to date, the Social Security Administration Office of the Inspector General dedicated a day during National Consumer Protection Week as National SLAM the SCAM Day, to remind individuals of how to spot these pesky scam calls. The goal of Slam the Scam is to raise awareness during Consumer Protection Week on prevalent government imposter scams and invite consumers to slam down the phone on these scammers! In honor of SLAM the SCAM Day, the Consumer Assistance Program (CAP) is reminding you to SLAM the SCAM and hang up on government imposters.
Receiving a call from someone claiming to be from the government can be alarming. These calls can be threatening in nature, claiming your personal information or identification was involved in a crime, or money is owed to a federal agency. On the other hand, sometimes these calls are more positive which offer fake opportunities for government grants, entitlements, or benefits. In 2021, the FTC reporteda[TM1] total of 396,302 scam reports relating to government imposters. In Vermont, government and legal authority imposter scams clocked in at the fourth most reported scam last year. This accounts for 9% of the 5,154 scams reported to the Consumer Assistance Program (CAP) in 2021, compared to 41% of the top scams reported to CAP in 2018. While the FTC numbers can be startling, there has been an average 7.3% yearly decrease of reported loss to government imposters, meaning consumers did not provide funds. To continue the declining trend of loss to scams, we need your help. To help reduce these fraudulent attempts, CAP will break down popular government imposter scams to help 1) identify the scam, 2) review what to know about the scam, and 3) provide some tips on how to navigate government impersonation scams.
Hang Up on Government Imposters!
Social Security Number Phishing
Identify It: You may get a call, text, email, or even a direct message on a social media platform from someone claiming to be from the Social Security Administration or Magistrate’s Office. The scammer may claim your Social Security benefits are ending or will be suspended unless funds or personal information about yourself is provided. Sometimes there are even threats of arrest or legal action to be taken against you. They will ask you to pay with gift cards, wire transfers, peer-to-peer payment methods (EX: Zelle, Venmo, PayPal, CashApp, etc.), or mailing cash. We have also seen an increase in requesting cryptocurrency, as these transactions are untraceable.
What to Know: The Social Security Administration would never call you threatening to cut off benefits or suspend your Social Security number. Instead, these are scammers looking to steal your money and identity by gathering your personal information. The Social Security Administration would never contact you via text message, email, or through social media. The only time Social Security will contact you by phone is if you request a call from them. Otherwise, most if not all correspondence occurs through mail. A legitimate government agency would never request money be sent by wire transfer, gift cards, pay with cryptocurrency, or mailing cash. Ignore these fraudulent attempts, and if the call is a robocall, do not press any buttons. If you need to speak with the Social Security Administration, call your local office using the Social Security Office Locator. You may also report the scam directly to the Social Security Administration Office of the Inspector General.
Medicare/Medicaid Imposter
Identify It: Scammers will call, often from a spoofed caller ID number, and pose as Medicare or Medicaid representatives to gain your personal information and money. CAP finds these scams are most frequent during times of open enrollment. The scammers will state they need your Medicare/Medicaid card number or Social Security number to keep your coverage active and verify medical information. The calls may also claim that coverage is expiring or in need of renewal. Scammers will also ask if you received a “new Medicare card”, often referred to as a “gold card” or “red, white, and blue card”. They may claim to be offering sought-after medical supplies or test kits in exchange for your ID.
What to Know: Never provide your Medicare number or other personal information and payment to unknown callers. In general, Medicare cards do not expire. Medicaid, on the other hand, provides coverage for a year with the option to renew yearly. This is done through Vermont Health Connect or Department of Vermont Health Access through the Agency of Human Services. Unless you have called Medicare using the 800 number on the back of your card and requested a callback, Medicare will not call you. If a phone call is required, you would receive a letter from Medicare to schedule a call. Medicare representatives will never call you to verify your information, sell you products, tell you that your coverage is expiring, or to issue you a new card. In Vermont, representatives of the State Health Insurance Assistance Program (SHIP) at 1-800-642-5119 through local Area Agencies on Aging can help address Medicare questions. Other questions and concerns about Medicare coverage can be directed to Medicare at 1-800-MEDICARE.
IRS Impersonator
Identify It: The scammers will call claiming that they are from the IRS and that you owe them for back taxes. Sometimes the call will begin with a robocall asking you to press a number or to confirm your personal information. They will ask you to pay immediately, and the caller might threaten you to say that the local police will arrest you, legal action will be taken, or your tax documentation will be suspended if you don’t pay. They could even provide some legitimate information like your Social Security number to make you believe that they are related to the IRS, but they are using this call to gain money and more information from you. The scammer usually requests the payment in a specific way, such as wire transfers, access to bank accounts, gift cards, mailed cash, or cryptocurrency.
What to Know: If the IRS contacts you, it would be by mail, not by phone unless you requested a callback. They may call you only after sending you two letters by mail. The IRS will never ask you to pay debts by phone, nor demand a particular payment method. Lastly, legitimate IRS employees will never threaten you. If you didn’t receive written notification about a tax issue and receive a call claiming to be from the IRS, don’t engage. Do not press any numbers, give personal information, or provide funds. This could lead to more scam calls. In this situation, the better thing to do is hang up the phone.
Identify it: The scammer will pose as a police officer, an attorney, or any person with legal authority. They will mention pending lawsuits or government debts involving you and will threaten arrest or legal action. The solution provided by the scammer is to send money, and your problem will disappear. But they will call again, saying that something went wrong, often requesting more money. Variations of this scam can involve immigration issues and the scammer using your legal status in the U.S. to threaten you with deportation and visa revocation.
What to Know: Law enforcement agents, like police officers, sheriffs, or other government employees, will not warn you ahead of time about pending warrants. If you were going to be sued, the papers would be served without notice. The government will never call and threaten you. The best thing to do is hang up the phone and call the legitimate agency’s phone number to check about possible lawsuits, immigration status, and debts. If you are concerned about your immigration application, petition, or status, contact the United States Citizenship and Immigration Services directly.
More Government Impersonation Scams
United States Postal Service (USPS)
Identify It: You may receive a call, email, or most commonly a text from a number you do not recognize, with a “tracking link” for a package or a notice a package was unable to be delivered by USPS. Scammers may also claim to be from U.S. Customs and Border Protection (CBP) regarding a package containing illicit items. In the communication, there may be a number to call or a link to view the tracking information. Once connected with the scammers, you are prompted to pay a fine to avoid arrest or legal action. You may also be prompted to provide additional personal information about yourself to ensure the package can be delivered. In terms of employment opportunities at USPS, please be aware of where the job is being posted and what the scammers are asking for. Offers are created to be enticing by alleging outlandish benefits, guaranteed jobs, or claim they will hire you on the spot.
What to Know: If you are not opted in for text communications from USPS or receive a text from a number not associated with USPS, this is a scam. Additionally, if you were not planning on receiving a package, chances are it is not legitimate. If you receive a package that you did not order, mark it “return to sender” and bring the package to your local mail carrier. If you are questioning if the claimed delivery is real, call your local USPS office to confirm if a package exists. If you are given a tracking number, you can check the legitimacy by using USPS’s Tracking page. U.S. Customs and Boarder Protection posted a press release a few months ago, warning consumers about this scam as well.
Government Funds (grants and unclaimed funds)
Identify It: These types of imposter scams focus on a variation of “free money” scams while pretending to be calling from a government agency. CAP receives the occasional notice about a scam call that claims to be from the State Treasurer, claiming there is “Unclaimed Property” for the individual to claim. Unclaimed Property is any lost or abandoned money that someone has not claimed, usually from past business dealings such as refunds and rebates, an overpayment on an account, or funds that were unclaimed in a financial account that was closed. In order to release those funds, the scammer will ask a fee to be paid, generally claiming the money is for tax purposes or interest on the funds. CAP has also received reports regarding the “Community Development Block Grant” or other government grants, where individuals have received texts and social media messages from fake profiles pretending to be a government employee. You are prompted to provide personal information and told you must pay a fee to receive your grant money.
What to Know: You would never have to pay money to claim your “Unclaimed Property” through the Office of the State Treasurer. You do not have to pay a fee to claim your Unclaimed Property. You may file for your Unclaimed Property online or by mail with the Office of the State Treasurer. To find out more about unclaimed property, go to USA.gov. The government does not contact you about available grants, you contact them. Legitimate grants require an application and are to be used for specific purposes. In addition, if you did apply for a grant, you do not need to pay money to receive the grant. You may find available federal grants at grants.gov.
How to Navigate Government Impersonation Scams:
If you suspect that you are being targeted by a scam, the best thing you can do is not respond. If you receive a scam call, SLAM the SCAM by hanging up! Do not call back the number. If you get an email, text message, or social media direct message, do not engage and mark the correspondence as “Junk/Spam” or delete the message. NEVER give out any personal information, money, or allow access to your devices to someone claiming to be from the government. If you are worried the claims may be true, contact the department directly using a trusted number. If you cannot find one, call CAP to inquire about legitimate contact information. Report scam encounters to CAP. Please see below for information on how to report scams to our office.
Do not trust caller ID. Instead, vet your calls by listening to your voicemail messages. Scammers are known to “spoof” legitimate phone numbers and names of government agencies, using fake identification of government and law enforcement agencies. These scammers can use aggressive tones or create a sense of urgency to provide the information or funds they are requesting. Often, the scammers will say not to tell anyone you spoke with them and to keep your conversation a secret. Do not isolate. Tell a trusted friend, family member, or member of your community to help you navigate this situation. CAP cares and is here to talk with you about the scam call you received.
To report scams, please visit our scam reporting form: https://ago.vermont.gov/cap/stopping-scams/. If you have difficulty accessing the form, call our office at 800-649-2424 to report the scam over the phone.
Learn more about imposter scams on our imposter scam prevention video and resource page: ago.vermont.gov/imposter-scam
BURLINGTON – In recognition of National Consumer Protection Week, Attorney General T.J. Donovan announced the top 10 consumer complaints received by the Consumer Assistance Program (CAP) in 2021. CAP, a partnership between the Attorney General’s Office and the University of Vermont, offers a free mediation service for Vermont consumers, including small businesses. In 2021, CAP received 1,173 complaints and recovered more than $240,000 for Vermont consumers. Claiming the list’s top spots are complaints involving vehicles, retail, and home improvement, respectively – representing approximately 44 percent of all complaints filed.
“I want to thank CAP for the services they provide to Vermonters. Whether they are resolving a consumer complaint, helping a Vermonter get a refund, or providing guidance to a victim of identity theft, CAP is always there to help. I encourage all Vermonters with a consumer complaint to reach out to CAP for assistance.
Attorney General T.J. Donovan
The following are the top 10 consumer complaints received by CAP in 2021:
Rank
Consumer Complaint Issue
Number of Complaints
1
Motorized Vehicles Common issues included defective merchandise; failure of state inspection; misrepresentation; and unsatisfactory service/repair.
199
2
Retail Common issues included failure to deliver; refund policy/refund disputes; defective merchandise; and unsatisfactory service.
187
3
Home Improvements Common issues included unsatisfactory service/repair; criminal home improvement fraud concerns; failure to perform; improper installation; and deposit refund dispute.
132
4
Health/Medical Common issues included unauthorized billing; excessive estimate/charge; and defective merchandise.
83
5
Fuel Common issues included pricing complaints; refund delays; propane tank removal delays; billing disputes; contract disputes; and safety concerns.
81
6
Housing and Real Estate Common issues included landlord-tenant issues; security deposit disputes; and warranty of habitability disputes.
77
7
Banking, Credit and Finance Common issues included debt collection; credit reporting disputes; and financing/loan issues.
67
8
Home Furnishings Common issue included defective merchandise, often involving new appliances.
59
9
Athletics Common issues included refund policy disputes for seasonal passes, and failure to deliver services.
30
10
Delivery, Moving and Storage Common issue included delayed deliveries.
29
CAP’s Top 10 Consumer Complaints of 2021
Though not represented in the list of consumer complaints, scams continue to be of concern to Vermonters. Earlier this year, Attorney General Donovan released the top 10 scams reported to CAP. In 2021, CAP received 5,154 scam reports, up slightly from the previous year. New twists on old scams involving computer tech support and fraudulent online listings represented nearly a quarter of all reports filed by Vermonters. More information on stopping scams is available at ago.vermont.gov/cap/stopping-scams/.
CAP offers a free mediation service to all Vermont consumers, including small businesses. If you are a consumer in need of assistance, please contact CAP by calling 1-800-649-2424 or visiting ago.vermont.gov/cap.
A National Consumer Protection Week feature. “National Consumer Protection Week (NCPW) is a time to help people understand their consumer rights and avoid frauds and scams” (FTC).
Ten years ago, the influx of scam calls through automation began. In two days, the Consumer Assistance Program (CAP), which traditionally logged around twenty scam reports per month, received hundreds of scam reports over two days. By the end of 2012, CAP averaged 145 scam reports per month. Of the first robocalls Vermonters reported were the card services scam, which claimed interest rates could be lowered on their bank credit cards. Next came claims of free gift cards from a specific retailer, who was offering nothing of the sort. What soon followed was a rush of new scams; claims that free life alert devices were available, the infamous IRS scam (responsible for 4,261 reports in 2016), which morphed into the SSN phishing scam, and countless others. Reports of scams have not dropped below the 5,000 mark since before 2015 in large part due to robocalls. After nearly a decade, it’s clear these calls are not going away on their own.
While scam nature varies, the one thing these scams have in common is the criminal use of expanded phone technology. In short, scammers have learned how to manipulate our phone systems to make millions of unscrupulous calls per minute. As long as they continue to make money, they will continue to call with enticing offers and troubling spiels.
How a Robocall Gets to You – Consumer Assistance Program – Learn more
Telltale signs of robocall scams:
A computer/automated/robot voice
Pressure to act immediately
A request for something: your information/your money
To the demise of the robocall scam industry, there are steps you can take as a consumer advocate to avoid these calls. By being aware and not engaging with these calls and making these scams less successful, you are doing your part to stop robocall scams. Learn more about stopping scams by opening the Blocking Unwanted Calls tab on CAP’s website. You can also listen to a previously recorded Vermont Edition about stopping and blocking robocalls.
Here’s what you can do when you receive an unknown call:
Pause: Take time to reflect – if a call is unexpected, disengage.
Take steps to verify by making note of the contact and doing research, including checking a trusted source.
Discuss scams with friends and loved ones regularly. Storytelling induces learning. The simple act of communicating with others about scams can help prevent others from becoming victims.
Keep on reporting them. Our office has been part of a bipartisan taskforce of attorneys general and federal law enforcement to relieve consumers of unwanted calls. Your robocall reports are used to aid this taskforce in tracking down criminal syndicates.
With the help of federal authorities and a large U.S. voice provider, our office has been able to track down US intermediaries and hold them accountable for sending scam calls to your phone.
Love fills us with joy, lifts us up, and makes us feel alive. As determined by a recent Stanford University study, for many, love is found online.
Technological advances and the move of our social lives and networks to online platforms has shifted the dating world to unchartered territory–online dating websites (Match, Zoosk, OurTime, Plenty of Fish, OKCupid, eHarmony), dating apps (Bumble, Tinder, Hinge), gaming platforms (Words With Friends, Sociable, Yahtzee with Buddies) and unassuming networks (Facebook, Instagram). As if the dating world were not challenging enough to navigate. Now, those looking for love must also learn how to create a true connection through tech, while avoiding scammers.
New data from the Federal Trade Commission show that more consumers than everreport falling prey to romance scammers.
Consumers reported losing $547 million in 2021 alone.
Reported losses to romance scammers were up nearly 80 percent compared to 2020.
At the end of last year, our office released a video and toolkit alerting Vermonters about imposter romance scams that can take place on dating platforms. Before looking for love online, check out the video and tools we created to help you to identify unscrupulous love interests and relationships of confidence.
