Every day people get ripped off by scam artists. To help against Medicare fraud, we participate in the Illinois Medicare Fraud Patrol project.

Use this link to view more Medicare Fraud Patrol information.

Protecting your personal information is the best line of defense in the fight against Medicare fraud and abuse. Medicare loses billions of dollars each year to errors, fraud, and abuse. You can make a difference by helping to identify and stop these illegal activities!

Most people don’t realize how easy Medicare fraud is to recognize and stop. For example, Medicare does not give items away at no cost. Claims that you can receive “free” medical care are often fraudulent.

In fact, Medicare does not pay the full amount for the purchase of medical care, supplies, and equipment. The difference in the amount that Medicare pays and what medical care actually costs is made up either by the beneficiaries’ out-of-pocket co-pay or by his or her medical supplement insurance, often called Medigap insurance.

You are generally the one in the best position to recognize when a bill for some sort of medical service appears to be wrong. You are also in the best position to apply what some people call the “smell test,” if an offer doesn’t smell right, then it’s probably rotten.

Here is what you can do to help fight Medicare errors, fraud, and abuse.

• Treat your Medicare card and Social Security numbers like a credit card or bank account number–never give them out to a stranger.
• Medicare doesn’t call or visit you to sell you anything.
• Only carry your Medicare card when you know you will need it.
• Record doctor visits, tests and procedures in a medical journal and compare them to your Medicare Summary Notice.
• Save your Medicare Summary Notices and Medicare Part D Explanation of Benefits. Shred them after you no longer need them.

Here are some common steps you can take to detect errors, fraud, and abuse.

• Always review your Medicare Summary Notices and compare them with your medical journal.
• Look for charges any items or services you did not actually receive.
• Look for items which are billed twice.
• Look for services that were not ordered by your doctor.

Other types of fraud include billing for nursing care services when in-home workers are actually doing household chores, offering or accepting referral fees from another medical provider in exchange for a client referral, misrepresenting services on a claim form or service calendar in order to obtain payment not earned, charging patients for filling out Medicare claim forms, and billing for the 20% co-payment when it has already been paid by the patient’s insurance company.

Here are some rules from Medicare to help protect you:

• Approved plans will have a “Medicare-Approved” seal on their materials.
• People who are selling Medicare drug plans can’t come to your home uninvited to sell or endorse any Medicare-related product, but they can call you about their plan.
• Drug plans can’t enroll you into a drug plan over the telephone unless you call them, or unless you are adding prescription drug coverage to a Medicare Advantage Plan or other Medicare Health Plan you already have.
• Drug plans can’t ask for payment over the telephone or Internet. The plan must send you a bill if you enroll over the telephone or Internet.

If you suspect errors, fraud, or abuse of Medicare, ask for an explanation from the medical provider. If this fails to satisfy you, contact the Senior Medicare Patrol hotline at 1.877.808.2468. This hotline was established for reporting errors, fraud, and abuse in the Medicare and Medicaid programs. It will ensure that your complaint gets into the right hands.

Before you call, collect as much information as possible, such as the medical provider’s name and any identifying numbers, the type of service or item billed, and date of the service. Be ready to provide a reason you believe Medicare should not have paid.

Use this link to read the entire quick facts sheet on identity theft and fraud.

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