Great Aunt Sadie certainly doesn't look like a criminal, but she may be helping others carry out criminal acts. You see, Sadie never really looks at all her medical bills, explanations of benefits or all the other things that are mailed to her. She says it gets too confusing. She was happy to help those nice people from Medicare who called and asked her all those questions. She wasn't sure she needed a mobility scooter, but the salesman was so nice, helped her to see its benefits and insisted that Medicare would pay for it. She may not know it, but Great Aunt Sadie may be helping companies and health care suppliers defraud Medicare.
Fraud costs Medicare one billion dollars every year. We, as taxpayers, end up paying for it with higher health care costs. Waste, fraud and abuse take critical resources out of our health care system, and contribute to the rising cost of health care for all Americans. By working together to eliminate fraud, we can cut costs for families, businesses and the federal government, and increase the quality of services for those who need care. We also can stop Medicare fraud from inflicting major financial and emotional damage upon those who are victimized.
Most doctors, health care providers, suppliers and private companies who work with Medicare are honest. However, there are a few who are not. Be suspicious of doctors, health care providers, or suppliers that:
- Advertise "free" consultations to people with Medicare;
- Offer equipment or services for free, then ask for your Medicare number for "record keeping purposes;"
- Use high-pressure or scare tactics to sell you expensive medical services or diagnostic tests;
- Call or visit your home claiming to represent Medicare or the federal government; or
- Tell you that if you will give them your Medicare number, they'll make sure Medicare pays for an item or service.
The best way to protect yourself and your family from Medicare fraud is guard your Medicare information much like you would guard your bank account or credit card numbers. Carry your Medicare card with you only when you need it, and never let anyone else borrow it or use it. If your Medicare card is lost or stolen, report it right away. Call Social Security toll-free at 1-800-772-1213 (TTY 1-800-325-0778) for a replacement.
People with Medicare get mailings, such as medical bills, summary notices and explanations of benefits. Fraudsters count on you to not really examine these mailings. But, if you do and compare them to your own records and receipts, you may be able to spot potential red flags of fraud, including: charges for something you didn't get, billing for the same thing twice and services that were not ordered by you or your doctor. If you see something that doesn't add up ask your care provider or plan administrator.
The Stop Medicare Fraud website (www.stopmedicarefraud.gov) can help you identify, protect against and report Medicare fraud. If you suspect Medicare fraud, call 1-800-447-8477.
If you have questions about Medicare, contact the Department of Insurance's Ohio Senior Health Insurance Information Program (OSHIIP) at 1-800-686-1578 or Medicare at 1-800-633-4227.
Don't let yourself or Great Aunt Sadie become an accomplice to Medicare fraud.
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