Medicare Fraud 2024

Medicare fraud is very common. So common in fact, that Medicare has a Medicare Fraud Prevention week every June to help folks learn more about and foil these scams. This year, Medicare Fraud Prevention Week is the week of June 3, 2024. However, in the spirit of being proactive, we decided to remind you about Medicare fraud well in advance of June. Keep on reading for more information about how to stop Medicare fraud scams.

Medicare fraud includes many schemes, from fraudulent billing for sham tests to medical identity theft when one’s Medicare number becomes compromised. These schemes defraud the government out of billions every year, and often affect individuals bottom lines as well. The result is higher Medicare premiums for everyone to attempt to compensate for the fraud. Pretty grim, isn’t it. Nevertheless, there is plenty you can do. 

You can easily foil Medicare fraud. One way to combat Medicare fraud is to review your Medicare statements regularly, including your Medicare Summary Notice (MSN) and Explanation of Benefits (EOB). For those that don’t know, MSNs and EOBs are given to all Medicare beneficiaries and explain what the health care provider billed for, the amount approved by Medicare, what Medicare paid and what the beneficiary might be billed. By checking these notices on receipt, you can catch services that were billed to Medicare by fraudsters that you didn’t receive or that were more costly than the service you received. 

Another way to combat Medicare fraud is to disengage from the fraudsters. Disengage from them by refusing to provide your Medicare number or other personal information to anyone other than a trusted health care provider. Medicare will never call you and ask you for your Medicare number or personal information. Disengage from the fraudsters by refusing to fall for high pressure sales tactics. Fraudsters prey on emotions such as fear to override your logical responses and get you to fall for their tricks. Finally, don’t accept offers of free services. Medicare will never try to sell you anything. And if something seems too good to be true, it likely is.

If you catch any instances of fraud in your MSNs or EOBs or in any communications with a scammer, it is easy to report the fraud. Simply report the issue to your local Senior Medicare Patrol (SMP), who can analyze it and refer it to the appropriate law enforcement agency. For you Colorado readers out there, your local SMP is the Colorado Department of Regulatory Agencies, Division of Insurance, and you can call them at 1-800-503-5190. If you don’t want to report the suspected fraud to your SMP, you can also call local law enforcement, call 1-800-Medicare, or call the US Department of Health and Human Services Office of the Inspector General (OIG). You can reach the OIG by calling 1-800-HHS-TIPS (1-800-447-8477).

And of course, you can always call Benefits in Action if you need to learn more about Medicare fraud and how to report it. We are a Senior Health Insurance Assistance Program (SHIP) site. Our unbiased SHIP counselors can provide information about Medicare fraud. Not only that, but Benefits in Action also provides a host of other services as well. So, if you are interested in learning more about Medicare fraud or the other services provided by Benefits in Action, call 720-221-8354 or email info@benefitsinaction.org. Until next month, stay healthy and stay safe.

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