Avoiding Medicare Fraud

Medicare Fraud

Medicare fraud affects many seniors each year, with the number of affected seniors is on the rise. Medicare fraud is illegal, and an operation that seniors should report as soon as they suspect any foul play. Not only does it hurt Medicare’s operations, but it also hurts the seniors involved. There are many ways to stay protected from Medicare abuse and fraud, and all seniors should take part in these precautions.

Medicare Fraud

When talking about fraud, it can get complicated and extensive. However, Medicare fraud breaks down into a simple concept: Medicare fraud is the use of an individual’s Medicare information for personal gain. This type of fraud is always intentional in nature.

Medicare fraud can include:

  • The use of one’s Medicare status to get services or medications for another individual
  • Submitting false claims to get money
  • Using one’s Medicare card to gain health services

These are only a few of the ways that individuals can fall victim to Medicare fraud. Typically, there are multiple types of people who commit these offenses. These people could be looking for personal gain, or be groups or organizations looking to take advantage of exposed seniors. It doesn’t matter who commits these crimes; it is still a serious offense that can often lead to imprisonment.

Medicare Abuse

Slightly different from Medicare fraud, Medicare abuse is any questionable practice that results in unnecessary or unreasonable costs to Medicare. Usually, abuse refers and applies to falsified payments. This includes improper billing procedures or charging too much for services or supplies. If not caught in time, Medicare abuse can sometimes lead to Medicare fraud. Both situations are illegal and are punishable by law.

Avoiding Medicare Fraud and Medicare Abuse

To avoid Medicare fraud and abuse, the best way is to keep track of all your Medicare payments and transactions. These transactions include any goods or services you are receiving from Medicare, any payouts you have received, and any notices you get from an insurance company or Medicare. After you obtain these documents, make sure to review them. It will be evident if there is any abuse or fraud taking place. If there is, it is pertinent that you report it immediately.

Reporting Medicare Fraud and Medicare Abuse

If you notice that you might have fallen victim to a Medicare fraud or abuse scheme, you must report this to protect yourself financially and legally. There are multiple ways to report this illegal activity. However, before you report, you must have a specific set of information about the crime. This information includes:

  • Provider name or any ID number included on documents
  • The date of the fraudulent items or services
  • A list of the services or items in question
  • The date that appears on your MSN
  • Your name and your Medicare number
  • A detailed description of why you believe Medicare did not need to pay for your goods or services
  • Any additional information you might have

After getting this information, it is time to report. You can do this by:

  • Calling Medicare directly at 1-800-MEDICARE (1-800-633-4227)
  • Reporting the fraud or abuse online
  • Calling the Inspector General at 1-800-HHS-TIPS (1-800-447-8477)

Additional Concerns

 If you have any additional concerns or worries about Medicare fraud, please feel free to refer back to this article. If you have any signs that you are a victim of Medicare fraud, you must contact Medicare as soon as possible. During the Medicare supplement buying process, we can assure you that your information is safe and confidential. We can help ease your worries during this process and prepare you for all potential scenarios. Give us a call at (800) 310-2550 or get your Medicare supplement quotes online.

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