Medicare fraud occurs when a healthcare provider purposely files a claim for services Medicare does not cover. For example: A medical equipment vendor bills Medicare for equipment a patient never receives or a doctor bills Medicare for services or tests that were never performed. Using someone else’s Medicare card to obtain medical services or supplies also constitutes Medicaid fraud.
Here are some measures you can take to avoid committing or becoming a victim of Medicaid fraud:
- Only accept services that you need.
- Do not give out your Medicare information to anyone except healthcare providers and plans contracted by Medicare and individuals who work with Medicare.
- Always check your medical bills, explanations of benefits and Medicare summary notices for inaccuracies.
- Understand what is and isn’t covered by Medicare so you can question providers who claim that Medicaid will pay for for services or products that aren’t normally covered.
- Suspect anyone offering free medical equipment in exchange for your Medicare number.
- Suspect anyone offering free consultations to Medicare recipients, who won’t charge co-payments without first checking on your ability to pay or who use pressure tactics to sell expensive services or tests.
If you suspect Medicaid fraud, you can call the Centers for Medicare & Medicaid Services (CMS) Hotline at 1-800-633-4227. Healthcare providers who suspect Medicaid fraud should call the Health and Human Services (HHS) Office of Inspector General (OIG) Hotline at 1-800-447-8477.
