Medicare fraud is big business, and like most businesses, it has adapted to the new environment of the COVID-19 pandemic.
“The public health emergency created an opportunity for fraudsters to modify and repurpose existing schemes,” a spokesperson for the Centers for Medicare & Medicaid Services, or CMS, said in an email. CMS has seen bad actors take advantage of wider demand for telehealth, COVID-19 testing and vaccines as avenues for identity theft and fraudulent billing.
The Department of Health and Human Services’ Office of Inspector General, or HHS-OIG, investigates fraud, waste and abuse in federal health care programs, including Medicare. Nearly 9,000 calls came into its fraud hotline each month, on average, from April through September 2021, according to HHS-OIG’s Spring 2022 report to Congress.
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Calling a fraud hotline is one of several actions Medicare beneficiaries can take to protect themselves. Here are five tips to help you avoid, detect and report Medicare fraud.
1. Protect your medicare number
In the wrong hands, your Medicare number could be used to steal your identity or submit fraudulent medical bills.
“Our top tip is to guard your Medicare number just like your Social Security [number] and credit cards,” the CMS spokesperson said. “You should only share your Medicare number with trusted health care providers or verified COVID-19 vaccine administrators.”
Unexpected callers or visitors who ask for your Medicare information are suspicious, especially if they claim to work for Medicare. According to CMS, Medicare will never visit you at home, and a Medicare representative would ask for your Medicare number by phone only if you’ve given permission in advance.
2. Beware of free gifts
Fraudsters might try to get your information by offering you something for free in exchange. If you’re asked to provide your medical or financial information and promised a supposedly free gift or service, “that’s something to question, or at least run by a medical professional that you trust,” says Isaac Bledsoe, an HHS-OIG criminal investigator.
Common examples of free offers might include COVID-19 tests, genetic testing services, or durable medical equipment like walkers or braces.
3. Don’t get talked into unnecessary care
Some schemes involve billing for expensive services that you might not need. For example, unscrupulous COVID-19 testing sites might add on unnecessary respiratory pathogen panels that can cost upwards of $500. That’s according to a January 2022 white paper by the Healthcare Fraud Prevention Partnership, a public-private anti-fraud group.
If you’re not certain, check with a trusted health care provider …….