What Is Fraud & Abuse?
Medicare fraud happens when Medicare is billed for services or supplies you never got. Medicare fraud costs Medicare a lot of money each year.
Abuse occurs when doctors or suppliers don’t follow good medical practices, resulting in unnecessary costs to Medicare, improper payment, or services that aren’t medically necessary.
Examples of possible Medicare fraud
How to Spot & Report Fraud
Spotting Fraud
When you get health care services, record the dates on a calendar and save the receipts and statements you get from providers to check for mistakes. Compare this information with the claims Medicare processed to make sure you or Medicare weren’t billed for services or items you didn’t get.
Watch a video on how to spot and report fraud
3 Ways to Review Your Original Medicare Claims
- Look at your Medicare Summary Notice (MSN).
- Visit www.MyMedicare.gov.
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
Reporting Fraud
If you think a charge is incorrect and you know the provider, you may want to call their office to ask about it. The person you speak to may help you better understand the services or supplies you got. Or, your provider may realize a billing error was made.
If you’ve contacted the provider and you suspect that Medicare is being charged for a service or supply you didn’t get, or you don’t know the provider on the claim, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048
3 Tips for Fighting Fraud
You can help stop dishonest people by identifying and reporting cases of potential fraud.
3 easy things you can do to fight fraud:
- Review your Medicare claims to make sure they are accurate. Check them early — the sooner you see and report errors, the sooner we can stop fraud.
- Learn how to protect your personal information.
- Be on the lookout for suspicious activity.
Learn more about protecting yourself and spotting fraud at StopMedicareFraud.gov or by visiting the local Senior Medicare Patrol office in your area.