Medicare fraud and abuse can occur everywhere, leading to increased medical costs and taxes for all. Instances of such activities include:
– A healthcare provider submitting claims to Medicare for services or supplies you never received, such as a consultation that never happened, or medical equipment like a lumbar support that you didn’t receive.
– A healthcare provider billing Medicare multiple times for a single service or product you received only once.
– An individual who misappropriates your Medicare information or card and utilizes it to file false claims under your identity.
– An entity promoting a Medicare prescription plan not endorsed by Medicare.
How to recognize & halt Medicare fraud & abuse
Should you suspect fraudulent activities, consider reaching out to your healthcare provider’s office for clarification. They might help clarify the charges or identify any discrepancies in their billing.
Should you have concerns about Medicare being billed for services or goods you did not receive, or if your Medicare identification or card is stolen, dial 800-MEDICARE to report any suspicions of fraud or abuse.
| If you encounter: | Get in touch with: |
|---|---|
| Fraudulent behavior or misconduct by a provider with Original Medicare (encompassing bogus claims or claims for services not rendered by a provider) | 1-800-MEDICARE (1-800-633-4227)
or The U.S. Department of Health and Human Services – Office of the Inspector General |
| Fraudulent behavior or misconduct within a Medicare Advantage Plan or a Medicare prescription plan (including illegitimate claims) | 1-800-MEDICARE (1-800-633-4227)
or The Operations Medicare Drug Integrity Contractor Qlarant |
What you should have available when making a call:
-
- Your full name and Medicare Identification Number.
- Details on the healthcare provider in question, along with any specific details you possess.
- The questioned item or service and the date you supposedly received it.
- The sum that Medicare consented to and disbursed.
- The date documented on your Medicare Summary Notice or your health plan’s Explanation of Benefits, or the claim itself.
Discover more on the official website of the US Government Medicare program.
