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Learn how to prevent, detect, and report Medicare fraud, errors, and abuse:  Prevent Medicare Fraud

Learn More About Medicare Coverage Relating to COVID-19

2020 SMP Office of Inspector General Report

Medicare Fraud 101

According to Government estimates, Medicare lost $52 billion to fraud, abuse and improper billing in FY2017. Medicare fraud typically involves rogue health care providers or medical suppliers who bill the program for services, equipment or medication that they don’t actually provide, or else inflate the cost of those items. Some will even falsify patients’ diagnoses to justify unnecessary tests, surgeries and other procedures or write prescriptions for patients they’ve never examined. Others use genuine patient information, sometimes obtained through identity theft, to create fake claims.

One of the most effective ways to combat against Medicare fraud is to review your Medicare statements and make sure the dates and services listed are correct. If something doesn’t look right, call your medical provider’s office. 

Be a fraud fighter!  If you can spot a scam, you can stop a scam.

 

Free Medicare Device Scam

One tell-tale sign that should make every consumer suspicious is when something is offered “for free.” These free offer scams are often associated with Medicare.  The program spends around $6 billion a year on medical devices, and a market this big draws scammers.  In a medical equipment scam, someone reaches out with an offer of a “free” brace, wheelchair or other device. All they need is your Medicare number.  Once they have it, scammers can use it to bill the government for devices and services that aren’t needed.

Medicare fraud results in higher deductibles and copays for Medicare beneficiaries, and can even put affected patients at risk. Be suspicious of unsolicited free offers and never give out your Medicare number to anyone who isn’t a trusted health care provider.

Be a fraud fighter!  If you can spot a scam, you can stop a scam.

 

Becky From Medicare

For the past few months thousands of robocalls have been hitting U.S. phone lines claiming to be “Becky, from Medicare.” And trust us, this is a conversation you’ll want to skip.

A target will receive a prerecorded call from “Becky from Medicare” and is asked to press 1 to talk to a representative to learn about free genetic testing. For those who interact with Becky (or one of her friendly colleagues), she’ll claim they are eligible for genetic testing to screen for diseases that Medicare will pay for. They will ask for the target’s Medicare number and mailing address to send a test kit with instructions.

This is a scam, pure and simple. All these crooks want is your Medicare number so they can bill Medicare for tests, devices – whatever their flavor of the day. These fraudulent charges cost Medicare billions each year.

To protect yourself – and save taxpayer dollars - only share your Medicare number with trusted health care providers; calls out of the blue for free resources from Medicare are scams – full stop.

 

Medicare Open Enrollment Scams

It’s open enrollment season, which also means it’s Medicare fraud season. Eligible beneficiaries have until December 7 to shop for the best deal for their health care dollar. Unfortunately, some of the deals out there won’t be deals at all. 

Just like in other years, Medicare scams spike during open enrollment season with scammers posing as insurance providers calling and emailing about free gifts or limited time offers. These scams are designed to capture information to bill Medicare for bogus services and treatment.

Be suspicious of anyone who calls, emails or visits you promoting a Medicare plan. Legitimate health plans can only contact you if you’ve requested information. Don’t give personal information to anyone who calls or visits out of the blue and always review your Medicare summary notice or explanation of benefits statement for fraudulent charges.