Medicare Fraud and How to Report it

It is unfortunate that many seniors are victims of Medicare fraud each year. Medicare fraud is unacceptable and it hurts more than just the operations of Medicare. It also terribly hurts the seniors. In the same way, some people abuse their Medicare benefits. This is also illegal and can cause considerable annoyance to the beneficiary. There are many ways to protect yourself from Medicare fraud.

What is Medicare Fraud?

Medicare fraud seems to be a large and complicated issue, but it is ultimately broken down into one main definition. It is the deliberate unlawful use of the Medicare information of another for personal gain. Some examples of Medicare fraud are:

  • Make false requests to receive an illegal payout
  • Use of your own Medicare card by another person to avail health services
  • Use of your Medicare status to receive medicines or services for another person

Medicare fraud can occur in any of these ways. These crimes do not have a single culprit. They can range from individuals looking for personal benefits to operations or groups who want to use vulnerable senior citizens. Regardless of who commits the crime, it can often be a costly affair and lead to prison.

What is Medicare abuse?

Medicare abuse is similar to Medicare fraud but a little different. Medicare abuse refers to any practice that ends in disproportionate or unnecessary Medicare costs. This type of abuse often applies to counterfeit payments, eg. improper invoicing processes or excessive costs for services or supplies. Abuse of medication, if not caught in time, can sometimes lead to fraud. Abuse is also illegal and a punishable offense.

How to avoid fraud and abuse of Medicare

To avoid fraud and abuse of Medicare, you should keep track of all your Medicare transactions. This includes any services or goods you receive from Medicare, disbursements and payment notifications you receive from Medicare or an insurance company. Once you have received these documents, you can determine if and when strange occurrences occur in your statements. As soon as you see this, it’s time to report. Get a 2019 advantage plan hereĀ

How do I report fraud and abuse of Medicare?

  • If you suspect or notice that a person or group is part of a fraud or abuse program, you must promptly report the crime. There are many ways to report Medicare fraud or abuse. Before you report the crime, you need to get certain information about the crime. This information include:
  • The name of the provider or an ID number
  • All services or objects that are questioned
  • The date of the fraudulent services or objects
  • The date displayed on your MSN
  • Total payment amount approved and paid by Medicare
  • Your Medicare name and number
  • A description of why you believe Medicare did not pay
  • Additional information you may have about the case

After receiving all this information, you will need to report the fraud or abuse next. To do this, you may:

Call Medicare: 1-800-MEDICARE (1-800-633-4227).

Report the fraud or abuse on the internet

Call the Inspector General Tip Line: 1-800-HHS-TIPS (1-800-447-8477).