How to Report
You, as the Medicare beneficiary, are the most important link in finding Medicare fraud. You know better than anyone what healthcare services you have received. Review your Medicare Summary Notice when you receive it, and make sure you understand all of the items listed.
If you donít remember a procedure that is listed, you should first call your physician, provider, or supplier that is listed on the Medicare Summary Notice. Many times a simple mistake has been made and can be corrected by your physician, provider, or supplierís office when you call.
If your physician, provider, or supplierís office does not help you with the questions or concerns about items listed on your Medicare Summary Notice and you still suspect Medicare fraud or if you cannot call them, you should call or write the Medicare company that paid the claim. The name, address, and telephone number are on the Medicare Summary Notice (MSN) you receive, which shows what Medicare paid.
Before contacting the Medicare claims processing company, carefully review the facts as you know them and as shown on the Medicare Summary Notice. Write down:
If you plan to write rather than call, clearly state at the beginning of your letter that you are filing a fraud complaint. This will help to ensure that your complaint is forwarded to the fraud unit.
Office of Inspector General Hotline
To further assist you, the Office of the Inspector General maintains a hotline, which offers a confidential means for reporting vital information. The Hotline can be contacted:
Please note that it is current Hotline policy not to respond directly to written communications.
Medicare's Florida Fraud Hotline
Medicare developed a dedicated fraud hotline for you to report suspected fraud if you live in the State of Florida or were charged for a service from a physician, provider or supplier in Florida and believe that the charge is fraudulent. This dedicated hotline will only address suspected fraud in the State of Florida.
If you are attempting to report specific information proving Medicare fraud, please provide as much identifying information as possible regarding your concern. Such information should include subject's name, address and phone number etc. Details regarding the allegation should include the basics of who, what, when, where, why, and how.