November Newsletter 2009

Medicare Fraud on the Rise: Don’t Be a Victim

Frightening headlines regarding Medicare fraud cases have been getting a lot of press, some valid and some not. What was once an uncommon white-collar crime is now a popular criminal scheme, in some cases even involving the Mafia. A 60 Minutes report on Sunday, October 25th noted Medicare fraud was now more common in South Florida than drug trading and has become one of the most profitable crimes in America totaling about $60 billion a year. The reason for increased Medicare fraud is due to it being more profitable and less risky than traditional organized crime activities due to the greater payoff and shorter prison sentences. Common Medicare fraud schemes include filing false claims and billing Medicare for drugs or medical equipment never received (or needed) by patients.

You might become a victim of medical identity theft if a criminal steals your personal information, such as your Social Security number or Medicare number. Consequently, Medicare fraud may not only waste taxpayer dollars but it could damage your credit rating. More importantly, it can be life-threatening if your medical records have incorrect information. It’s also important to remember that under Part A, you only get up to 60 days for hospital stays and up to 20 days for the skilled nursing facility benefit before you have to pay a coinsurance amount. The last thing you want to do is end up losing these allocated days because someone has stolen your Medicare card and is using up your benefits.

While programs are being implemented to reduce Medicare fraud, Medicare recipients can take matters into their own hands and learn about ways to be more vigilant in recognizing and reporting fraudulent activities. Here are some ways that you can protect yourself against Medicare fraud:

• Check the following for any unusual activity:
   o Medical Bills
   o Medicare Summary Notices
   o Explanation of Benefits
   o Credit Report
• Keep a record of your doctors’ visits, ordered tests and equipment, out-of-pocket costs, and medical bills
• Be wary of companies offering free medical products, equipment, tests or screenings in exchange for your Medicare number
• Do your homework and make sure you are working with a reputable insurance agent. If you ever have a question about whether you are working with a licensed agent, you can ask them for their agent ID number.
• Consider an insurance policy rider covering identity theft
• Shred documents containing your Medicare beneficiary number
• Bring in your mail as soon as it is delivered
• Refuse to sign blank or incomplete insurance forms

The FBI urges Medicare recipients to be protective of their Medicare beneficiary card and number. If you suspect Medicare fraud, report errors to your health care provider or contact the Medicare claims processing company listed on your Medicare statement.

Read the other November Newsletter articles:

• Seniors Save Big!
• Get Ready for Annual Enrollment – November 15th
• The 2010 Medicare Changes Are In