medicare fraud 325x215Each year, Medicare loses $60 - $80 billion to fraud and abuse. Money lost to fraud means increased costs, and can diminish the quality of care you receive. The Senior Medicare Patrol at the Center for Advocacy for the Rights and Interests of the Elderly is dedicated to curbing fraud and abuse in Medicare. Medicare beneficiaries who volunteer for the program are trained on what fraud looks like, how to teach beneficiaries to protect themselves and Medicare, and how to report problems. These messages, which the SMP calls Protect, Detect, Report, are delivered to consumers in the community in presentations and health fairs.

What can fraud look like? Billing for services or supplies never provided, double billing for a service or supplies, and incorrectly reporting diagnoses, procedures, medications, or equipment to get a higher payment. Or, billing for an hour of service (physical therapy, for example) but only receiving 15 minutes of therapy.

There are simple, practical steps you can take to prevent fraud. Treat your Medicare card and Social Security card as if they were credit cards. Never give personal information to someone who calls you or comes to your door. It’s okay to say NO and shut the door or hang up the phone. Your Medicare number is your Social Security number, so Medicare fraud and identity theft often occur together. Never give that number out in exchange for free services or products.
If something is truly free, the provider doesn’t need your number. Only take your Medicare card with you to medical appointments. If someone calls you or comes to your door claiming to be from Medicare, remember that they never send representatives to your home. Medicare and Social Security do not call you and ask for personal information. Never accept medical equipment or supplies from someone who calls you or comes to your door. If you need a piece of equipment, call your doctor first. If Medicare pays for something you don’t need, it may not pay for something you actually do need in the future.

Use a calendar or journal to record your doctor’s appointments and healthcare visits and tests. Check your health care statements to make sure the services and details are correct. Finally, if you suspect Medicare fraud, simply have questions, or would like to volunteer as a speaker, call the PA-SMP at CARIE: 1-800-356-3606 or visit www.carie.org. Help is free and confidential.

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