Medicare & Medicaid

Common Medicare Frauds Targeting Seniors


  1. Billing for Services Not Provided: Fraudulent healthcare providers might bill Medicare for services, tests, or procedures that were never actually performed.
  2. Upcoding: Providers bill for a more expensive service or procedure than what was actually provided.
  3. Unnecessary Services: Some providers might order unnecessary tests or procedures just to increase their Medicare billing.
  4. Durable Medical Equipment (DME) Fraud: This involves billing Medicare for unnecessary or non-existent durable medical equipment like wheelchairs, walkers, or diabetes supplies.
  5. Medicare Card Scams: Scammers call seniors claiming they need to verify their Medicare number or other personal information to issue a new card.
  6. Health Fair Scams: Fraudsters set up fake health fairs where they offer bogus testing to collect Medicare numbers and bill Medicare for nonexistent services.

Steps to Prevent Medicare Fraud

  1. Protect Your Medicare Number: Treat your Medicare number like a credit card number. Do not give it out to anyone except your trusted healthcare providers.
  2. Be Skeptical of Free Services: Be cautious of free services or products, especially if you are asked for your Medicare number.
  3. Review Medicare Statements: Regularly check your Medicare Summary Notices (MSNs) or Explanation of Benefits (EOBs) for services or supplies you did not receive.
  4. Be Aware of Marketing Scams: Be suspicious of marketers who offer “free” healthcare products or services in exchange for your Medicare number.
  5. Report Suspicious Activity: Report any suspicious calls or requests for your Medicare information.

Steps to Take if You Receive Unnecessary Medical Supplies

  1. Contact the Supplier: Call the company that sent the supplies and inform them that you did not order these items and you do not need them.
  2. Notify Medicare: Report the incident to Medicare by calling 1-800-MEDICARE (1-800-633-4227).
  3. Report Fraud to the OIG: Contact the Office of Inspector General (OIG) if you suspect fraud. The OIG hotline is 1-800-HHS-TIPS (1-800-447-8477).
  4. Return Unwanted Items: If instructed by Medicare or the supplier, return the unnecessary supplies.

What to Do if Scammed at a Health Fair

  1. Contact Medicare Immediately: If you believe your Medicare number has been stolen, call 1-800-MEDICARE (1-800-633-4227) to report the incident.
  2. Monitor Your Medicare Account: Regularly review your Medicare statements for any fraudulent charges or unfamiliar services.
  3. File a Complaint: File a complaint with the Federal Trade Commission (FTC) at reportfraud.ftc.gov.
  4. Report to the OIG: Report the fraudulent activity to the Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477).

By being vigilant and informed, seniors can protect themselves from becoming victims of Medicare fraud.

-Lê Nguyên Vũ –

Sources

  • Medicare.gov: Protect yourself from Medicare fraud
  • U.S. Department of Health and Human Services, Office of Inspector General: Reporting Fraud
  • Federal Trade Commission: Consumer Information

Medicare Fraud Hotlines

  • Medicare: 1-800-MEDICARE (1-800-633-4227)
  • OIG Fraud Hotline: 1-800-HHS-TIPS (1-800-447-8477)