Medicare Fraud Increases YOUR Medicare Premiums
Medicare, the U.S. Government's health insurance program,
provides medical coverage for citizens aged 65 years or older and
certain disabled persons younger than 65 years. With over one billion
claims processed annually, Medicare has become the country's largest
managed provider of medical care. With more than a billion transactions,
tens of millions of members, and an increasingly-complex system,
Medicare fraud and abuse of the system is inevitable.
The overwhelming majority of health providers,
suppliers, and institutions who provide Medicare services do so
honestly and by the regulations. However, unscrupulous individuals
have determined how to commit Medicare fraud to the tune of millions
of dollars every year. Those Medicare fraud thefts have the effect
of raising Medicare premiums for the honest members.
Most Medicare mistakes are honest ones rather than Medicare fraud.
They are probably transcription errors, typographical errors, and
many other types of problems that can occur when humans interact
with large amounts of paperwork. If you see these types of errors,
contact the doctor who provided those services and discuss them. The
problem can usually be solved that way. However, if a provider
begins billing you for services that used to be free (or that you
know to be free under Medicare), or uses other unusual billing
strategies, it might be Medicare fraud.
Medicare fraud can take several forms. One is to bill Medicare for
services and products that were never delivered. Another is to bill
Medicare for more services than were actually provided to the
patient. Overbilling and billing for returned medical equipment are
other examples of Medicare fraud.
The government is fighting back against Medicare fraud. The goal is
to ensure that Medicare only does business with reputable and honest
medical health care providers, institutions, and suppliers. The
fight against Medicare fraud includes the Centers for Medicare and
Medicaid Services (also known as the CMS), those who provide
Medicare services (e.g., doctors, hospitals, etc.), those who
receive Medicare services (patients), and several federal law
enforcement and consumer protection agencies of the U.S. government.
All Medicare members should examine their bills and statements
carefully. They should look for services billed but not provided,
extra charges, incorrect Social Security or Medicare numbers, and
other discrepancies.
If you suspect Medicare fraud and your doctor's office was unable or
unwilling to clear up the problem, contact the Medicare provider who
reimbursed the doctor for the Medicare claim. The Office of the
Inspector General maintains a hotline at 1-800-HHS-TIPS
(1-800-447-8477). Please retain all pertinent documentation,
including notes from any conversations you had with the provider's
office. Medicare fraud hurts everyone.
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