Scams and Fraud Related to Medicare

As more people engage in online activity following the start of the COVID-19 pandemic, scams and fraud have increased. According to a report from AARP, the rate of financial exploitation of older adults has more than doubled since early 2020.

The heath care and health insurance areas are especially rife with fraud. It is estimated that tens of billions of dollars are lost each year due to Medicare fraud. This leads to higher health care costs and taxes for all of us. Fortunately, there are ways to prevent and report fraud and scams.

Types of Medicare Fraud and Scams

Fraud and scams related to Medicare target both Medicare patients and the U.S. Centers for Medicare and Medicaid Services (CMS). Some common examples of fraud include:

• Theft of a person’s Medicare card or number and using it to submit fraudulent claims,
• A care provider charging twice for a service or medical device that they only provided once,
• A care provider charging for a service or medical device they never provided,
• A care provider billing Medicare for unnecessary services or equipment, and
• A company offering a person a Medicare drug plan that Medicare hasn’t approved.

Preventing Medicare Fraud and Scams

Preventing Medicare fraud and scams requires all of us to be vigilant. Here are some things you can do to help prevent Medicare abuse.

• Check your claims early and often.
• Compare the dates on your calendar that you received services with your Medicare statements to make sure you actually received the services Medicare is getting billed for and that the details for the services are correct.
• Check your statements and receipts to make sure your health care providers haven’t made any mistakes. If you find an error, call the provider and ask them about it. The error could be a simple billing mistake, or it could have been intentional. It is best to check.
• Make sure you know what the various Medicare health and drug plans cover and don’t cover before you join one.

Protecting Yourself from Identity Theft

Identity theft is when a bad actor uses another person’s personal information without their consent to commit fraud or other crimes. There are some things you can do and some things you shouldn’t do that will help protect you and the Medicare system.

• Do guard your Social Security number and your Medicare number.
• Do protect your Medicare card as though it were a credit card.
• Do become familiar with how Medicare uses your personal information. Medicare will let you know how they will use your information if you join one of their plans.
• Don’t give your Social Security card or number or your Medicare card or number to anyone who should not have it. People who needing to know your Medicare number include your doctor, health care providers, and Medicare personnel.
• Don’t allow anyone, except your doctor and your other health care providers, to view your medical records or recommend services to you.
• Don’t accept offers of gifts or money in exchange for free medical care.
• Don’t join a Medicare plan over the phone unless you called Medicare to join the plan.

Reporting Medicare Fraud and Scams

If you find an error or discrepancy in a statement from one of your health care providers, call them and ask about it. The discrepancy could be a simple error. If, however, you think you have detected an instance of fraud, contact Medicare at 1-800-MEDICARE (1-800-633-4227). Learn more about reporting Medicare fraud and abuse at Medicare.gov. In addition to contacting Medicare directly, it is a good idea to call a local elder law attorney.

Our law firm is dedicated to keeping you informed of issues that affect seniors who may be experiencing declining health. We help you and your loved ones prepare for potential long-term medical expenses and the need to transition to in-home care, assisted living care, or nursing home care.

This article offers a summary of aspects of elder law. It is not legal advice and does not create an attorney-client relationship. For legal advice, please contact our office today at (954) 315-1169 to schedule a consultation.