Medicare fraud is often in the news, but what is it, exactly? Fraud costs Medicare an estimated $60 billion a year and contributes to the rising cost of health care for all Americans. Once you understand what is involved, you can help prevent fraud.
Medicare fraud occurs when providers mislead Medicare into paying for services it shouldn't be paying for. Examples of fraud include: a health care provider, such as a doctor or hospital, billing Medicare for services you never received; a supplier charging Medicare for equipment you never got; or someone using your Medicare card to get medical care or supplies.
You can take steps to prevent fraud.
- Never let anyone use your Medicare number. Be very careful before giving your number out to anyone. Be suspicious of anyone who offers you free medical equipment in exchange for your Medicare number.
- Always check your medical bills, Medicare summary notices, and explanation of benefits for any inaccuracies.
- Understand what Medicare does and does not cover so you can question a provider who says you can get coverage for something that is not normally covered. For information on what Medicare does not cover, click here.
- Only accept services that you need.
- Be suspicious of a provider that advertises free consultations to people with Medicare, uses pressure or scare tactics to sell expensive tests or services, or doesn't charge copayments without first checking on your ability to pay.
If you suspect fraud, you should call the Health and Human Services Office of Inspector General's hotline at 1-800-HHS-TIPS (1-800-447-8477) or e-mail the Inspector General's office at HHSTips@oig.hhs.gov.