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Medicare Fraud Costs Taxpayers Millions: Ways to Prevent It

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Medicare Fraud Costs Taxpayers Millions: Ways to Prevent It

By Marlo Sollitto, AgingCare.com contributing editor

No one knows for sure how much Medicare fraud costs the American people, because much of the scams go undetected. What is known is this: at least $2.3 billion in false claims have been billed since 2007, when the Medicare Fraud Strike Force was formed by the Department of Justice (DOJ) and the department of Health and Human Services (HHS).

Fraud costs the Medicare Program millions of dollars every year, which results in higher health care costs for everyone. The Fraud Strike Force says you can do your part to stop fraud by reviewing Medicare statements to make sure Medicare is not charged for items or services that you or your elderly parents did not receive.

4 Scams to Look Out For During Medicare Open Enrollment

Here are some tips, provided by Medicare.

Know What Medicare Fraud Is

Some examples of possible Medicare fraud are:

  • A healthcare provider bills Medicare for services you never received
  • A supplier bills Medicare for equipment you never received
  • Someone uses another person’s Medicare card to get medical care, supplies or equipment
  • Someone bills Medicare for home medical equipment after it has been returned
  • A company offers a Medicare drug plan that hasn’t been approved by Medicare
  • A company uses false information to mislead you into joining a Medicare plan

Related:
“Spending Down” to Medicaid: One Caregiver’s Personal Journey
Medicaid’s ‘Cash and Counseling’ Allows Pay for Family Caregivers
What’s the Difference Between Medicare and Medicaid?

Medicare Fraud Costs Taxpayers Millions: How to Prevent It originally appeared on AgingCare.com

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24 comments

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1:49AM PDT on Oct 28, 2011

Perhaps a universal healthcare system is needed instead, whereby the hospitals, medical practioners, et al., are all brought under one umbrella in providing healthcare for all Americans, whatever their circumstances.
After all, if you can afford to spend the extraordinary amounts of money in maintaining your military machine, then you certainly can afford this. However, if it comes down to a choice, which of these two would you really want to enhance your wellbeing?
We have a system over here in the UK (currently under threat from our current Coalition Government) which provides just that, a health system free at the point of use.
Fuller details of how this socially inclusive service came into being can be found by typing in 'Aneurin Bevan' on your browser.

6:28PM PDT on Oct 27, 2011

I get so much med. mail it is hard to read it all. If you understand some of it, you are lucky.

4:25PM PDT on Oct 27, 2011

Have you ever tried to make sense of the bills you're sent from hospitals and doctors? It's a maze of coding and 16-letter words. Pretty easy to scam people, especially those who are old and confused and can't see well to begin with.

11:14AM PDT on Oct 27, 2011

thanks for sharing

10:13AM PDT on Oct 27, 2011

Something that's a bit more subtle and less likely to be found is all the unneccessary surgery done on the elderly. One lady I knew was in poor health, diabetic and slightly overweight and her doctor had her undergo gastric bypass surgery. The complications killed her! Later it was documented this surgery was completely unneccessary... I think there is quite a bit of this sort of abuse!

9:44AM PDT on Oct 27, 2011

Most of this involves paying attention, which the majority of people try to do. Unfortunately, there are many people who are past being able to figure out their treatments, much less their bills, and so are taken advantage of. We hear about the elderly being abused and robbed by relatives, who are probably participants in Medicare fraud, also. Doctors who are involved in fraud should lose their license, be fined, AND go to jail. Everyone else should be fined and go to jail. And the benefits they get in jail is a whole other subject...

8:34AM PDT on Oct 27, 2011

thank you

7:54AM PDT on Oct 27, 2011

I make sure that everything is legit on my summaries. I see several doctors--one once a year; one once every two years; one several times a year--and it would be easy for fraud to get through. Therefore, I double check everything. I haven't found anything yet, so I guess I've been lucky.

7:21AM PDT on Oct 27, 2011

We do know approx. the amount of fraud. The US govt. estimated 60 Billion dollars per year in medicare fraud. This article just represents company/organizational fraud....there are billions committed by individuals. The govt. says it's difficult to chase individual fraud so they typically don't.....However, if they didn't allow it upfront at the time of application for assignment of Medicare benefits...they'd save alot of time and money. I've written multiple times to the Whitehouse inquiring about this. They have hired 20,000 individuals for the IRS when the new healthcare plan is instituted re: to collect tax fees, but, they can't assign more employees to address this??

6:51AM PDT on Oct 27, 2011

Many people I know do not even look at the paperwork telling them what has been covered on their medicare claim. I guess one of the preventing fraud tips should have been OPEN the envelope and READ it!!!

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

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