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:
This is when 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 can have serious medical and legal consequences. For example, thieves may file false claims against your number. This fraud can lead to improper medical treatments, false diagnoses, recorded procedures that never occurred, and incorrect lab results.
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.
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Medicare cards do not expire.
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Medicare will not call you to offer a new Medicare card or request information about your current card or number.
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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 they want you to be aware of current changes to Medicare. Once they have your attention, they will request your personal identifying information.
Equipment and Supplies Coverage Issues:
Durable Medical Equipment (DME) must be prescribed by your physician or another healthcare provider. To qualify, you must use the equipment in your home. It can also be used in a hospital or nursing facility that provides skilled nursing or rehabilitative services.
Types of Abuse
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Unsolicited calls to market items such as diabetic testing supplies, or braces
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Requesting health information, such as Medicare numbers, or physicians names
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Billing for rental equipment before it is delivered
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Billing for equipment never provided
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Refusing to pick up equipment and continuing to bill
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Completing documentation to show medical necessity for a patient not known by the physician or treating practitioner
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Excessive amount of supplies
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Supplies delivered with no prescription
- “Free” supplies, and 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 protects your credit. It makes it much harder for identity thieves to open new accounts. Additionally, this service is entirely free. All you need to do is:
- Contact a credit bureau and ask that they put a fraud alert on your account.
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- 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.