Fraud and Abuse

Fraud and Abuse

Senior Medicare Patrol (SMP) works with Medicare beneficiaries and volunteers to help prevent, detect and report healthcare fraud, errors, and abuse. If you think you have been a victim of Medicare Fraud please contact our office at 316-660-0126.

Medical Identity Theft:

Your Medicare number is misused, by a provider, supplier, or by an imposter posing as you. If your Medicare number is stolen or misused you will not be issued a new Medicare number. Identity theft may have consequences such as, false claims filed against your number, improper medical treatment, false diagnoses, recorded treatments that never occurred, incorrect lab results, or other misinformation.

Medicare Card Scam:

You may be contacted by someone telling you that you need a new Medicare Card. They may threaten you with the loss of your Medicare benefits. They will ask for personal information including your Medicare number, and bank account information.

• Medicare cards do not expire

• Medicare will not call you to offer a new Medicare card or request information about your current card or number

• If you lose your card you can request a new one from Social Security

Medicare “Changes” Scam:

Because there are often changes to Medicare scammers often use this as a way in to get personal information. Scammers might call and say that they want you to be aware of current changes to Medicare, they will then proceed to request personal identifying information.

Equipment and Supplies Coverage Issues:

Durable Medical Equipment (DME) must be prescribed by your physician or another healthcare provider. They are to be used in your home, a hospital or nursing facility providing skilled nursing or rehabilitative services are not considered home use.

Types of Abuse

• Unsolicited calls to market items such as diabetic testing supplies, or braces

• Requesting health information, such as Medicare numbers, or physicians names

• Billing for rental equipment before its delivered

• Billing for equipment never provided

• Refusing to pick up equipment and continuing to bill

• Completing documentation to show medical necessity  for a patient not known by the physician or treating practitioner

• Excessive amount of supplies

• Supplies delivered with no prescription

• “Free” supplies, they ask for a Medicare number 

Victims of Fraud

If you feel you have been a victim of fraud, you can place a fraud alert on your account. Placing a fraud alert on your account makes it more difficult for an identify thief to open more accounts in your name, and it is a FREE service. All you need to do is:

1. Contact a credit bureau, and ask that they put a fraud alert on your account.  

• • The most common credit bureaus are Equifax, Experian, and Transunion.
  • Once you contact one credit bureau, that bureau will notify the other bureaus.
  • The bureau will explain that you have the right to a free credit report which you can review.
  • The fraud alert stays on your account for a year.

For additional information, please visit the Federal Trade Commission's website.