Understanding Medicare Fraud

Medicare fraud involves dishonest practices aimed at receiving improper benefits or payments from Medicare. Perpetrators include healthcare providers, patients, or other individuals and organizations. Such fraudulent activities are illegal and can lead to severe consequences, including penalties and jail time.

 

Common Types of Medicare Fraud

Medicare fraud can take several forms. Some common examples include billing for services not rendered, upcoding (billing for a more expensive service than provided), and kickbacks for patient referrals. Patients may also misuse their benefits card by sharing it with others.

 

Tips to Guard Against Medicare Fraud

 

 

• Review Medicare statements: Regularly check your Medicare Summary Notices (MSN) or Explanation of Benefits (EOB) for unfamiliar charges.

 

 

• Protect your Medicare number: Treat your Medicare number like you would a credit card number. Do not share it without verification.

 

 

• Be cautious of unsolicited offers: Do not engage with individuals offering free services or medical benefits over the phone or email. Verify their legitimacy first.

 

 

• Keep personal records: Maintain records of your medical appointments, tests, and treatments to cross-reference with your statements.

 

 

Reporting Suspected Fraud

If you suspect Medicare fraud, report it immediately. You can contact Medicare directly at 1-800-MEDICARE or visit their website. Alternatively, reach out to the Office of Inspector General (OIG) through their fraud hotline or webpage.

 

Stay Informed and Vigilant

Staying informed about the potential risks and methods of Medicare fraud is crucial for protection. Regular updates from trusted sources can offer valuable insights. By remaining vigilant, you can protect yourself and the healthcare system from fraudulent activities.