Reporting Medicare Fraud & Abuse

Article from MEDICARE.GOV

Medicare fraud and abuse can happen anywhere. It’s important that you protect your Medicare card, number, and other personal information, and check your Medicare claims regularly.What are some examples of Medicare fraud?

To help spot and prevent Medicare fraud and abuse:

• Compare the dates and services on your calendar with the Medicare statements you get to make sure you got each service listed and that all the details are correct.

• Protect your personal information and become familiar with how Medicare uses it.

• Know what a Medicare health or drug plan can and can't do before you join. If you join a Medicare health or drug plan, the plan will let you know how it will use your personal information.

• Learn more about Medicare and recent scams.

Protect yourself from medical identity theft

Medical identity theft is a serious crime that happens when someone uses your personal information without your consent to commit Medicare fraud or other crimes. Use the following tips to protect yourself from becoming a victim.

Do:

• Check the receipts and statements you get from providers for mistakes, and call your provider’s office if you think a charge is incorrect.

• Remember that Medicare will never call you to sell you anything or visit you at your home. Medicare, or someone representing Medicare, will only call and ask for personal information in limited situations (like an agent or representative returning your call after you've joined a plan, reported fraud, or left a message for Medicare). 

Don’t:

• Give your Medicare card, Medicare Number, Social Security card, or Social Security Number to anyone except your doctor or people you know should have it (like insurers acting on your behalf or people who work with Medicare, like your State Health Insurance Assistance Program (SHIP). Get the contact information for your local SHIP.

  • What do I do if my card is lost, stolen, or damaged?

• Accept offers of money or gifts for free medical care.

• Allow anyone, except your doctor or other Medicare providers, to review your medical records or recommend services.

• Join a Medicare health or drug plan over the phone, unless you called and asked for help.

If you suspect fraud call 1-800-MEDICARE (1-800-633-4227)

or Report Medicare Fraud online.

If you have a Medicare Advantage Plan or Medicare drug plan you can also call the Investigations Medicare Drug Integrity Contractor (I-MEDIC)

at 1-877-7SAFERX (1-877-772-3379).