Medicare Fraud

A Google search of "Medicare Fraud" and "2006" produces nearly a quarter million "hits." Remember, the Medicare program is just one avenue of healthcare coverage, so that many articles in a single year is indicative of the overwhelming nature of this problem and the effect it has on our national economy.

Sometimes regular people commit the frauds, however it is far more often that it is the crime of choice for dishonest doctors, medical equipment providers, pharmaceutical providers or even hospitals.

The most important thing for consumers to be aware of is that your Medicare information and numbers are just as easily abused, probably even more so, than a credit card number. When you use a credit card, most stores ask for identification or require an identifying pin number. When you use a Medicare card/numbers, nobody is at the other end of the transaction looking at your photo ID. They are simply billing the government program, and the checks and balances guaranteeing the integrity of the transaction are, for the most part, missing.

Medicare is funded via taxation. YOU pay taxes. YOU fund Medicare. So...YOU are paying for fraud. More than $200 BILLION a year is lost in healthcare scams.

Treat your Medicare information as if it was private credit information. Because it is.

Report abuses of the system.

Review all doctor and hospital bills thoroughly.

Count the number of pills you are given. Is it correct?

Do not EVER give a telemarketer your Medicare numbers.

Don't accept "FREE" health examinations or other services, if you have to give someone your Medicare information to get those free services.

Don't accept "FREE" items (scooters, medical supplies, etc.), unless the arrangements are made by your medical doctor.

Report suspected fraud or abuse!

If you think you see Medicare fraud or abuse on your Medicare Summary Notice (MSN), follow these steps.

1. Call the health care provider on the MSN and ask. It might only be a billing error.

2. Call the 800 number at the bottom of your Medicare Summary Notice (MSN).

3. If you still think the charges are fraudulent, then contact a Senior Medicare Patrol (SMP) counselor in your local HICAP office (800-434-0222).

4. The counselor will help you decide if forwarding the case to the proper fraud investigation is the correct course of action.

5. You might be instructed to also call the U.S. Department of Health and Human Services, Office of the Inspector General at (800) HHS-TIPS; (800) 447-8477.