Protect Yourself from Medicare Fraud
Statistics from the National Council on Aging (NCOA) and other sources estimate Medicare loses approximately $60 billion annually to fraud, errors, and abuse. Experts caution anyone on Medicare is at risk for fraudulent charges and examples include:
Billing for services or supplies that were not provided
Providing unsolicited supplies to beneficiaries
Misrepresenting a diagnosis, a beneficiary’s identity, the service provided, or other facts to justify payment
Prescribing or providing excessive or unnecessary tests and services
Violating the participating provider agreement with Medicare by refusing to bill Medicare for covered services or items and billing the beneficiary instead
Offering or receiving a kickback (bribe) in exchange for a beneficiary’s Medicare number
Requesting Medicare numbers at an educational presentation or in an unsolicited phone call
Routinely waiving co-insurance or deductibles
Experts say fraudulent schemes are growing and there aren’t enough agents to keep up. The Office of Inspector General (OIG), which investigates Medicare fraud, works with a staff of approximately 450 agents for the whole country.
If you are on Medicare, you can help prevent some of the fraud as many schemes target beneficiaries directly by stealing their identities or enlisting them as unwitting accomplices. Medicare.gov advises seniors to start by protecting their Medicare card like they would a credit card. This includes not giving out the number to anyone other than your healthcare provider or other people you know should have it. In addition, they say it is important to check your Medicare Summary Notices (MSNs) or claims statements carefully. If you see a charge for a service you didn’t get or a product you didn’t order, it could be fraud. If you suspect fraud, report it at 1-800-MEDICARE.
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