Medicare fraud costs tax payers billions of dollars a year. It is estimated that $1 out of every $7 is spent on Medicare fraud, errors, waste and abuse.
The federal government is cracking down on abusers but they can’t do it alone. They need the help of all Medicare beneficiaries.
“The consumers are the front line defense,” said Betty Balderston, statewide coordinator for the Maine Senior Medicare Patrol. “They are the only ones who really know, along with the provider, if the service billed to Medicare was actually received.”
Preventing Medicare fraud begins at home. Senior Medicare Patrol advises beneficiaries to Protect, Detect and Report.
Protect your Medicare number. Treat it like a credit card. Never give the number out over the phone unless you initiated the call or to someone who comes to your door claiming to need it. If your card is lost or stolen, report it immediately to 1-800-MEDICARE.
Be alert to people who claim to know how to bill Medicare to get payment even if an item or service is not covered. This is a scam and should be reported.
Don’t accept free medical services or equipment in exchange for your Medicare number. Nothing is ever free. Unscrupulous providers will later bill Medicare for things you may have never received.
Detect fraud, errors, waste and abuse by monitoring your Medicare statements. Carefully look at each entry to be sure the service listed was provided.
“I tell people to think of their Medicare statement like a credit card statement,” said Balderston. “People don’t think of it as ‘their’ money being spent but it really is. The cost belongs to all tax payers.”
Report anything that looks suspicious on your statement. Contact the provider first because it may be a simple mistake. But don’t be put off. Balderston has had people report that when they called the provider, they were told “not to worry about it.”
“But they should worry about it, we all should,” she said. “It’s fraud and it adds up.”
If you don’t receive satisfaction from the provider’s office, then report your suspicions to SMP, which has volunteers and staff at each area agency on aging. Information will be gathered and the complaint will be forwarded to special investigators who contract with Medicare. And every complaint is taken seriously.
While some beneficiaries tried to report an instance of alleged fraud directly to Medicare only to be told that the complaint wasn’t “big enough” the situation is changing.
Reporting to Senior Medicare Patrol will generate action on the complaint.
For more information, call 1-877-353-3771 and ask for a Senior Medicare Patrol representative.
Carol Higgins Taylor is director of communications at Eastern Area Agency on Aging. E-mail Higgins Taylor at firstname.lastname@example.org. For information on EAAA, call 941-2865, toll-free (800) 432-7812, e-mail email@example.com or log on EAAA.org. TTY 992-0150.