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MEDICARE FRAUD COSTS taxpayers and
the government. Anyone can abuse the system
and commit health-care fraud: health-care
providers, suppliers, employees, companies.
Here’s some information to help you protect
yourself from related scams.
Examples of Medicare fraud you
might encounter include:
• Someone uses your Medicare card to get
unauthorized supplies, equipment or care
• A provider bills Medicare for services or
equipment that you never received
• A company offers a Medicare drug plan
that is not Medicare approved or uses false
information to mislead you into joining a plan
Protect yourself from Medicare
fraud by taking these steps:
• Make sure a provider is Medicare
approved. To see if a provider is Medicare
approved, visit medicare.gov or call
1-800-MEDICARE (633-4227).
• Keep a record. When you get health-care services, record the dates and save
receipts and statements in a file or notebook
from providers so you can track if any mistakes are made. Keep and review your
Medicare Summary Notices if you have
Original Medicare.
Take care with Medicare
CONSUMERconnection
• Check statements closely. If you aren’t
sure about a Medicare charge, call the service
provider, the supplier and the customer service
number on your statement immediately. If
you’re still not sure of a charge or are unsatisfied with a provider’s response to your inquiry,
call your local Senior Medicare Patrol (smp
resource.org), a group of trained volunteers
who show Medicare and Medicaid recipients
how to protect against, detect and report fraud.
• Protect your Medicare card and number. Carry your Medicare card and practice
discretion when giving out your Medicare
number. Follow the rules for protecting your
personal information: Generally, know who
you are sharing your personal information
with, be on guard for potential scams and do
not give out any sensitive information to
someone you do not know. If you think
you’ve lost your Medicare card, call the Social
Security Administration at 1-800-772-1213.
Be suspicious of doctors, health-
care providers or suppliers who:
• Tell you that tests become cheaper as
more of them are provided.
• Call and say they represent Medicare or
the federal government. Medicare will not call
and ask for personal information.
• Use pressure or scare tactics to sell you
expensive medical services or diagnostic tests.
Medicare-covered services are never a lim-ited-time offer.
• Offer non-medical transportation or
housekeeping as Medicare-approved services.
• Offer free Medicare services. If you
need to find a federally funded health center
that is free or low-cost, visit the Health
Resources and Services Administration (hrsa.
gov) or use the Partnership for Prescription
Assistance’s free clinic finder ( pparx.org).
If you suspect Medicare fraud,
contact the following:
• Medicare at 1-800-MEDICARE (633-
4227). Tips from beneficiaries help Medicare
David Horowitz is a leading consumer advocate. David’s daughter
Amanda Horowitz is the CEO
of Fight Back! and co-founder of
FightBack.com. Email David and
Amanda at info@fightback.com.
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identify scams and schemes as they are
emerging. Medicare takes action to stop the
bad behavior and makes sure such providers
are not providing services to people with
Medicare. You may be eligible for a monetary
reward if you report fraud and certain conditions are met.
• Your local Senior Medicare Patrol
• The Office of Inspector General (OIG)
Hotline Operations ( forms.oig.hhs.gov/hotline
operations). OIG Hotline Operations accepts
tips and complaints from all sources about
potential fraud, waste, abuse and mismanage-
ment in U.S. Department of Health and
Human Services programs.
• The Federal Trade Commission at ftc.
gov (if you suspect identity theft)
When you contact them, have the
following information on hand:
• Your Medicare number
• The provider’s name and identifying
number
• The payment amount approved and
paid by Medicare
• The date of the service or item in ques-
tion and the reason you think Medicare
should not have paid
• Any other supporting information you
have explaining why Medicare shouldn’t have
paid for a service or item C
Please note we are not licensed professionals in any field. If you are seeking advice you
should consult with your own licensed professional. We do not assume any liability or
responsibility for the interpretation, application or accuracy of any information provided.
When you get health-care services, record
the dates and save
receipts and statements in a file or notebook from providers
so you can track if any
mistakes are made.
