Prevent Medicare Fraud

Each year, Medicare estimates that it loses $60 billion due to fraud, errors, and abuse.

How to prevent Medicare fraud

Protecting personal information is the best defense.

  • Never give Medicare numbers to a stranger
  • Treat your Medicare information like you would a credit card
  • Don’t carry your card with you unless you are going to a medical appointment
  • Keep a record of your visits
  • Review your Medicare notices and explanation of benefits

Remember that Medicare won’t call and ask for your Medicare numbers.

Be aware of billing errors

Check for mistakes on your Medicare notices and explanation of benefits:

  • Services and charges you didn’t receive
  • Double billing of services
  • Services not ordered by your doctor

What are some healthcare fraud schemes?

There are a few common healthcare fraud schemes to be aware of:

You are asked to provide your Medicare number, credit card or bank information, or personal information for:

  • Offers of free services or medical supplies
  • Someone calling to verify your Medicare eligibility
  • An offer for a year’s supply of prescription drugs for a set fee

You and Medicare are billed for services not provided:

  • A doctor’s office bills for treatment or product you didn’t receive
  • A pharmacy dispenses prescriptions a few pills short but bills for the full amount

How can I protect myself against healthcare fraud?

  • Don’t give out any personal information.
  • Report suspicious phone calls.
  • Call Community Health Financial Services if you have questions or concerns about Medicare statements or billing.

To Report Medicare Fraud

Contact Medicare Directly:

  • Call 1-800-MEDICARE (1-800-633-4227). The TTY number for those with hearing impairments is 1-877-486-2048.
  • Report fraud online through the Medicare Fraud Report Form.

Contact the Office of Inspector General (OIG):

  • Call the OIG Hotline at 1-800-HHS-TIPS (1-800-447-8477).
  • File a report online with the HHS OIG.
  • Fax your report to 1-800-223-8164 or mail it to:U.S. Department of Health and Human Services
    Office of Inspector General
    Attn: Hotline
    P.O. Box 23489
    Washington, DC 20026

Senior Medicare Patrol (SMP):

Contact Your State Attorney General’s Office:

  • Many state attorneys general have hotlines or offices dedicated to handling Medicare fraud.