Don’t be a Victim of Medicare Fraud

The reports are alarming: The FBI says $60 billion is lost to health care fraud every year, while CNN Money estimates it’s closer to $100 billion. A big chunk of that is lost to organized fraud rings, but everyone is at risk of being a victim. Because you have Medicare, you may be more likely to be targeted.

Examples of Medicare fraud, according to the Stop Medicare Fraud website, include:

  • A health care provider bills Medicare for services you never received.
  • Someone uses another person’s Medicare card to get medical care, supplies, or equipment.
  • Someone bills Medicare for home medical equipment after it has been returned.
  • A company offers a Medicare drug plan that has not been approved by Medicare.
  • A company uses false information to mislead you into joining a Medicare plan.

How can you help make sure you are not a victim?

  • Guard your Medicare and Social Security numbers. Treat them like you would treat your credit card numbers.
  • Be suspicious of anyone who offers you free medical equipment or services and then requests your Medicare number. If it’s free, they do not need your number.
  • Do not let anyone borrow or pay to use your Medicare ID card or your identity. It’s illegal, and it’s not worth it.
  • If your Medicare card is lost or stolen, report it right away. Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) for a replacement. If you get benefits from the Railroad Retirement Board, call 1-877-772-5772, or visit www.rrb.gov.
  • Review any statements or your Part D Explanation of Benefits (“EOB” – this comes to you from Express Scripts Inc. every month that you have used your prescription drug benefit). If anything doesn’t make sense (were you billed twice for the same thing?) or does not look familiar (you do not take a medicine that is being listed on your EOB): Call Express Scripts, your doctor or VillageHealth Member Services.

IF YOU SUSPECT FRAUD, REPORT IT.

Si sospecha un fraude de Medicare, repórtelo: www.ethicspoint.com , 1-877-863-3362 (TTY: 711).

如果您懷疑有人Medicare欺詐行為，請在網站 www.ethicspoint.com 或致電 1-877-863-3362 (TTY: 711) 檢舉。

If you suspect fraud, the easiest way to report it is to submit your report online. Just click on this link:

Report Now

Or you can call Member Services at 1-800-399-7226, 8:00 a.m. - 8:00 p.m., 7 days a week. TTY users call 711. They will file a report with our Special Investigations Unit.

If you prefer you can report fraud to EthicsPoint, an independent organization, at 1-877-863-3362. Email them at: www.ethicspoint.com.

You can also report suspected Medicare fraud to this government hotline: 1-800-HHS-TIPS (1-800-447-8477) or TTY: 1-800-377-4950. Or email to: HHSTips@oig.hhs.gov.

FOR MORE INFORMATION

Follow these links to learn more about Medicare fraud:

Sources: Federal Bureau of Investigation, Administration on Aging, Department of Health and Human Services, Department of Justice

Follow this link to learn more about Medicaid fraud: