How To Prevent
Medicare Fraud and Abuse
You can protect yourself by knowing about common schemes used to steal
money from you and Medicare. Here are some tips: Some of that money
went into the pockets of greedy individuals who are intent on cheating
Medicare.
Is there a doctor in the house?
Protect Your Medicare Number Who pays for fraud? You pay!
Know That Medicare Does Not Offer Items and Services
Watch Out For Marketing Scams; Know How To Deal With Them
Look Out For These Scams!
Remember
Fraudulent Medicare Marketing Schemes
A day hardly p***** that we don't hear of Medicare fraud or Medicare's
ever rising cost to the American taxpayer. Many "Baby Boomers" even
question whether Medicare will be there for them when they retire.
Medicare spends more than $228 billion dollars annually for health
care, and most of that money is spent on items and services needed by
the program's beneficiaries. Some of that, however, went into the
pockets of greedy individuals who are intent on cheating Medicare.
So why should you care? You should care not only because what they're
doing is wrong and because they're cheating you, but also because you
will eventually be asked to make up for the dollars they steal. Fraud
causes your annual deductible and the amount of your monthly premium
to increase.
Let's look at what you can do to protect yourself from some of the
more common schemes.
PROTECT YOUR MEDICARE NUMBER
There are so many schemes used to steal from you and Medicare.
However, no scheme can succeed unless the fraudulent biller has your
Medicare number.
They'll tell you the service is free; that they need your Medicare
number for their records. Don't believe them. They need it to bill
Medicare. Only give your number to providers you know and trust.
KNOW THAT MEDICARE DOES NOT OFFER ITEMS AND SERVICES
Be suspicious of a provider or representative of a provider who claims
to represent the Social Security Administration, the Health Care
Financing Administration (HCFA) or Medicare.
Medicare does not authorize any provider to call or visit you.
Medicare does not recommend that you receive an item or service from a
particular provider.
WATCH OUT FOR MARKETING SCAMS; KNOW HOW TO DEAL WITH THEM
Telemarketing-- Most businesses that use telephone sales are honest.
However, there are some criminals that will try to con you into
helping them steal from Medicare.
They exploit your basic trust of people. They may even say that they
represent Medicare, the government, or even a senior citizen group.
They sound as though they are really interested in your health and
welfare. They may even claim to be from a taxpayer group trying to
"save" Medicare.
They'll ask about your health. They'll offer to assist you, and maybe
your doctor, in meeting your health needs. They may even promise to
call your doctor and consult with him or her. They'll then ask for
your Medicare number. When they ask for your Medicare number, you know
it is fraud just waiting to happen.
So, what's the best way to deal with these calls?
The National Consumer's League reminds us that "It's hard to hang up."
Swindlers know how to take control of the conversation, either by
pretending to be very friendly or by using bullying tactics.
If you can't hang up, tell them you're not interested, or that you'll
have to discuss it with your doctor. Ask them for the name and address
of the provider. (You'll need that for your re****t to Medicare.) At
the end of the call, you can even tell them that you're going to check
out their offer with Medicare or the Office of Inspector General.
WHATEVER YOU DO, DON'T GIVE THEM YOUR MEDICARE NUMBER. Don't make up a
number. It may belong to another beneficiary.
Then re****t the call either to the insurance company that processes
your Medicare claims or the Inspector General Hotline at 800-447-8477.
Door-to-Door Schemes -- In recent years, the door-to-door marketing of
home health services, nutritional supplements, and other items and
services has increased in popularity. Sales people may use the
telephone or the mail to announce a planned visit.
These marketers are known to use high pressure techniques to get you
to agree to accept what they're selling. Some may not leave unless you
agree to take what they're selling, or until you let them see your
Medicare card.
These people usually get paid "by the number." In other words, they'll
get, say $50 a number. These "salesmen" are part of the scheme
intended to steal from you and Medicare. They'll do anything, say
anything, and promise you everything in exchange for that number.
LOOK OUT FOR THESE SCAMS!
One or more persons, often wearing white lab coats, show up and
introduce themselves as working for a local clinic. They say that they
visit seniors to make sure that people are getting the medical care
they need. They'll tell you their services are free. They may offer to
take your temperature, pulse and blood pressure.
They'll suggest that you need some additional testing. They'll ask you
to come into their clinic. Again, the services are free - absolutely
no charge. They may even offer to pick you up if you can not get to
the clinic.
Once they have your Medicare number, they bill Medicare for the tests
and clinic visit as well as the "ambulance trip." They won't contact
your doctor.
There have been door-to-door salesmen offering nutritional
supplements. The canned drink was of course free to the beneficiary.
Medicare would pick up the cost and they only needed their Medicare
number. Each month someone would drop off a case. They claimed the
government wanted them to have the product.
Don't open the door to these people. If you do, tell them you're not
interested and close the door.
Don't give these people your number. If you believe you need what they
are offering, call your doctor.
Re****t these people to Medicare, or the Office of Inspector General
(OIG) Hotline. If you believe they have broken State or local laws,
call the local police or the State Attorney General's Office.
Through the Mail -- These marketers often represent themselves as
being endorsed or recommended by the government. Note the envelope.
See how much it resembles the envelope in which you get your Social
Security check or tax refund. Same color. Same size. Note the "eagle"
emblem. Inside the envelope, they make their pitch.
Under federal law, marketers are not permitted to use words, letters,
symbols, or emblems to give the false impression that what they are
selling is approved by the Social Security Administration, the Health
Care Financing Administration (HCFA), or the U.S. Department of Health
and Human Services.
If you receive such communication through the mail, Internet, or your
FAX machine, re****t it to the Office of Inspector General Hotline.
Health Fairs/Free Screening-- Health care institutions sometimes offer
free health screening. They are often seen in shopping malls, county
fairs and senior centers. They typically offer services ranging from
taking your pulse and blood pressure, to chest x-rays, to even blood
tests.
The legitimate ones never ask you for your Medicare number. Take
advantage of these free tests, but know that some unscrupulous persons
have used free health screenings as an op****tunity to steal from
Medicare.
How do you tell the honest screener from the dishonest one? If the
screening is free as advertised, they do not need to see your Medicare
number. If they ask you for your number, walk away. If they want the
number, they plan to bill. They've lied to you.
REMEMBER
Who pays for fraud? You pay!
Medicare does not ever market items or services.
Never give your Medicare number to someone on the phone, in the mail,
at your front door.
Medicare does not encourage the use of covered items and services.
Don't ever accept or agree to any service until your doctor approves
it.
If you think you have run into one of these schemes, re****t it to
Medicare. Call the Office of Inspector General Hot line at
800-447-8477.
If You Would Like Help "Take two aspirin and call me in the morning.
That will be $125.00 Pay the girl on the way out."
--- Dr Doomer, D.O.
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