Beware of Fraud
By Mark Johnson R.CPhT., Axtell-Rite Pharmacy, Texoma LIVING WELL Magazine
It seems that you cannot open a newspaper or watch the local news without hearing of some type of scam or fraud.
Medicare fraud, sadly, is becoming more and more prevalent. Medicare fraud happens when Medicare is billed for services or supplies you never got. Medicare fraud costs Medicare a lot of money each year. In 2011, the government recovered an historic $4.1 billion and has recovered a record-breaking $10.7 billion of healthcare fraud over the last three years. In October 2012, Medicare Fraud Strike Force operations in seven cities led to charges against 91 individuals––including doctors, nurses and other licensed medical professionals––for their alleged participation in Medicare fraud schemes involving approximately $432 million in false billing.
As a part of the new resources dedicated to fighting fraud, the Obama Administration has significantly expanded funding for Senior Medicare Patrols––groups of senior citizen volunteers who educate and empower their peers to identify, prevent and report health care fraud. In 2012, 54 states and territories were awarded with funding to support the Senior Medicare Patrol programs. Last year, these programs taught more than two million beneficiaries how to look for Medicare fraud. Local Senior Medicare Patrol offices provide assistance when such issues are identified, so that mistakes are corrected and suspected fraud is referred to the appropriate authorities.
If you suspect errors, fraud, or abuse when you use Medicare––or if someone tries to sell you a product or service you don’t need––report it.
What do I need to have to report errors, fraud, or abuse?
- The provider’s name and any identifying number you may have.
- Information on the service or item you are questioning.
- The date the service or item was supposedly given or delivered.
- The payment amount approved and paid by Medicare.
- The date on your Medicare Summary Notice.
- Your name and Medicare number (as listed on your Medicare card).
- The reason you think Medicare should not have paid.
- Any other information you have showing why Medicare should not have paid.
To report suspected errors, fraud, or abuse, you can contact the Office of Inspector General at 800-447-8477.
Be Well and Be Well Informed.
