What examples of Medicare fraud can you find?

Common examples of Medicare fraud include billing for services that were not provided, billing of unnecessary services, misrepresenting dates of service, or providers of service, and paying kickbacks for patient referrals.

Is there a lot of Medicare fraud?

Medicare beneficiaries are targeted by scammers and identity thieves all year long, but fraudulent activity tends to increase around the Medicare Open Enrollment (MOE) period that runs from October 15 to December 7 each year.

Is Medicare fraud a crime?

Defrauding the Federal Government and its programs is illegal. Committing Medicare fraud exposes individuals or entities to potential criminal, civil, and administrative liability, and may lead to imprisonment, fines, and penalties.

What factors might be red flags for Medicare fraud?

Some red flags to watch out for include providers that:

Offer services “for free” in exchange for your Medicare card number or offer “free” consultations for Medicare patients.
Pressure you into buying higher-priced services.
Charge Medicare for services or equipment you have not received or aren’t entitled to.

How serious is Medicare fraud?

Medicare fraud is illegal, so it’s more serious than a billing error. Medicare fraud involves doctors or beneficiaries abusing the Medicare system for their own personal gain.

Why is Medicare fraud difficult?

The total amount of Medicare fraud is difficult to track, because not all fraud is detected and not all suspicious claims turn out to be fraudulent. The Congressional Budget Office estimates that total Medicare spending was $528 billion in 2010.

What should you do if you suspect Medicare fraud?

If you suspect Medicare fraud, do any of these: Call the fraud hotline of the Department of Health and Human Services Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8477). TTY users can call 1-800-377-4950. Visit forms.oig.hhs.gov to file a report online.

What are some examples of Medicare fraud?

Some of the most common examples of Medicare fraud allegations include: Billing for Medically-Unnecessary Supplies or Services – Physicians will often face Medicare fraud charges based upon allegations of billing Medicare for services or medical supplies that were not medically necessary.

What are some examples of medical billing fraud?

One example of medical billing fraud is the inclusion of services never rendered. A doctor’s office might bill for a blood test that never occurred, for example, or a pharmacist could bill for medication she did not dispense. More commonly, care providers engage in an activity called upcoding,…

What constitutes Medicaid fraud?

Medicaid fraud is an intentional deception or misrepresentation made by an individual with the knowledge that the deception or misrepresentation may result unauthorized benefit to an individual or some other person. Medicaid fraud includes any actions or inactions that constitute fraud under federal or state law.

How are Medicare Whistleblower rewards paid?

How are Medicare whistleblower rewards paid? In order to receive a whistleblower reward, you must hire a lawyer who can file a False Claims Act complaint, which contains detailed allegations of the fraud. If you are the first person who has properly filed a complaint of Medicare fraud and have sought the reward, you may receive between 15 and 30 percent of the total amount that the government ultimately recovers based on your report.

What examples of Medicare fraud can you find? Common examples of Medicare fraud include billing for services that were not provided, billing of unnecessary services, misrepresenting dates of service, or providers of service, and paying kickbacks for patient referrals. Is there a lot of Medicare fraud? Medicare beneficiaries are targeted by scammers and identity thieves…