Protect Yourself from Medicare Fraud

Medicare fraud is a serious issue that affects millions of Americans and costs the government billions of dollars annually. It involves intentionally deceiving Medicare to receive unauthorized benefits or payments. This article will explore what Medicare fraud is, its consequences, how to protect yourself, and how to report it. 

What is Medicare fraud? 

Medicare fraud occurs when individuals or organizations knowingly submit false claims or misrepresent facts to obtain payments from the Medicare program. Common examples include billing for services not provided, falsifying diagnoses to justify unnecessary tests, or using someone else's Medicare number to claim benefits. 

Medicare fraud is often grouped with Medicare abuse, which refers to practices that result in unnecessary costs to Medicare, such as overbilling or providing services that are not medically necessary.  

What are the consequences? 

The consequences of Medicare fraud are far-reaching and severe. For individuals committing fraud, the penalties include substantial fines, imprisonment, and exclusion from participating in federal healthcare programs. Beyond these direct repercussions, Medicare fraud creates widespread harm to the healthcare system. It drains critical resources, escalates healthcare costs, and diminishes public trust in the integrity of Medicare. 

On a broader level, Medicare fraud has tangible effects on beneficiaries. It can contribute to higher premiums and increased out-of-pocket expenses for individuals. Additionally, when fraudulent claims siphon funds from the system, those resources are no longer available to improve healthcare services for people who genuinely rely on Medicare for their medical needs. Stolen numbers, when used to file false claims, further exacerbate the issue by undermining the security of personal benefits and complicating efforts to detect fraudulent activity. 

How can I protect myself from Medicare fraud? 

Protecting yourself from Medicare fraud starts with vigilance. Here are some practical steps: 

• Guard your Medicare number. Treat your Medicare card like a credit card. Never share your Medicare number or Social Security number with anyone except trusted healthcare providers. 
• Review your statements. Regularly check your Medicare Summary Notices (MSNs) or Explanation of Benefits (EOBs) for errors. Look for charges for services you didn’t receive or discrepancies in billing. 
• Be skeptical of offers. Be cautious of unsolicited calls, emails, or visits offering free medical services or equipment. Scammers often use these tactics to steal personal information. 
• Educate yourself. Understand what Medicare covers and the rules for your plan. This knowledge can help you spot suspicious activities. 
• Report suspicious activity. If something doesn’t seem right, don’t hesitate to report it. Early reporting can prevent further fraud. 

How can I report Medicare fraud? 

If you suspect Medicare fraud, it’s crucial to act promptly. Visit the Medicare website to report suspected fraud. Be prepared to provide details such as the provider’s name, the service date, and the nature of the suspected fraud. You can also reach out to the Office of Inspector General (OIG).   

Medicare fraud is a significant problem that affects everyone, from individual beneficiaries to the entire healthcare system. General Electric Credit Union (GECU) wants to remind members to exercise caution if someone asks for their personal information, including bank account or Medicare numbers. GECU in particular will never initiate a call asking for this information. Discover more tips to protect yourself by visiting our Security Center.