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How can you protect yourself from Medicare fraud?


Common Medicare Scams, from Post Office Boxes to Prosthetic Legs
U.S. Attorney Alex Acosta shows a wheelchair that was used in a case of Medicare fraud worth more than $2.8 million in 2006. Patients would sit in the chair to prove they needed it, then submit a photo of that to Medicare.
U.S. Attorney Alex Acosta shows a wheelchair that was used in a case of Medicare fraud worth more than $2.8 million in 2006. Patients would sit in the chair to prove they needed it, then submit a photo of that to Medicare.
Associated Press/J. Pat Carter

There may be many perpetrators of Medicare fraud. Some patients may "rent out" their Medicare number, claiming they received services so that someone can bill the system in exchange for cash. Doctors may get involved so that they can pad their billings. Some people will just set up a post office box, pretend to be doctors or medical equipment suppliers, and start billing Medicare with stolen numbers. In 2009, the Associated Press reported that even mobsters and violent criminals are getting in on the act -- compared to drug dealing, the payoff is more lucrative and the punishment less severe. Hotspots for Medicare fraud include Miami, Los Angeles, Detroit and Houston [source: Kennedy].

Though Medicare scams are constantly evolving, one common type of fraud involves medical equipment such as wheelchairs, walkers or hospital beds for home use. Doctors or suppliers may bill Medicare for delivery of a wheelchair yet never actually deliver the device. Or, they may show up at a patient's doorway with a wheelchair, claiming it's a gift from Medicare. Another scheme involves billing Medicare for prosthetic arms and legs -- for a person who has never had an amputation [source: Potter].

The Medicare program doesn't have the resources to investigate every single claim, and it tries to process payments quickly. If a doctor reports that that he or she provided services to a Medicare patient, Medicare tries to pay that doctor for the work as soon as possible. The key to the doctor or the medical supplier's claim, though, is a Medicare number. If someone has your Medicare number, that person can wreak a lot of havoc before being caught. That's why it's very important to guard this number with vigilance. Many recent Medicare scams have been successful because senior citizens just gave their numbers away on the phone. For example, the Affordable Care Act dictated that Medicare recipients would receive rebate checks to account for the prescription drug coverage gap. The checks were to be mailed directly to seniors, with no action on their part, but some scammers started calling seniors to ask them for their Medicare number, claiming it was necessary to complete the rebate process.

So how can you tell when your doctor is reliable? And when is it OK to give out your Medicare number?


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