Medicare Fraud Costs Everyone
Medicare fraud occurs when a bill is submitted to Medicare for services or products that were never received or needed. Some examples of this type of fraud are billing for tests that were never performed, billing for equipment that was never received, and using another person’s Medicare card to get medical services, supplies, or equipment.
It should be noted that most healthcare professionals are honest and clerical errors do happen. However, the dishonest few cost taxpayers and Medicare recipients hundreds of millions of dollars in higher taxes, premiums, and co-pays every year. According to the U.S. Department of Justice, 494 new matters involving Medicare fraud were lodged in 2005. Along with the wasted money of services and products not needed or received, the federal government spent about 100 million dollars related to healthcare enforcement in 2004.
What does this mean to you? It means if you are receiving Medicare benefits you can dramatically aid in reducing the amount of Medicare fraud that happens every year.
ecently an eighty year old man in Florida noticed a mistake in his Medicare statement. The statement showed charges in the amount of $24,653 for services he had never received. Medicare had already contributed nearly $18,000 to the bill. Not only had he never received the services but he had never stepped foot into the medical center that claimed to have provided services.
Another example takes us to Texas where a doctor has been sentenced to four and a half years in prison and was ordered to pay $432,000 in restitution for his role in a scam designed to rip-off the federal government to the tune of 12 million dollars. The doctor talked elderly patients into seeking unnecessary power wheelchairs. When the patients ordered the chairs, Medicare was fraudulently billed and the doctor allegedly received kickbacks from the wheel chair supplier.
So what do you do? Your role in the fight against Medicare fraud begins when you receive your Medicare Summary Notice or MSN. The MSN is a detail of the services and supplies you received and what Medicare paid. Check your MSN for mistakes! Make sure that the services and products listed were the same services and products that you received.
If you find a mistake call the healthcare provider and ask for clarification, with all the terminology of the industry it is quite possible that the person you speak to may be able to help you understand what it is you received. If you aren’t satisfied with the results you get from the provider, you still have options. First call or write the company that sent you the MSN. Second you can call the Inspector General’s hotline at 1-800-HHS-TIPS or send an email to hhstips@oig.hhs.gov. You could be eligible to receive a reward of up to $1,000 for your information.
For more information on Medicare fraud and how you can combat this growing concern please visit the Medicare website, Medicare.gov, or contact Jason Hafer of Heritage at Milford Assisted Living Community by phone at 302-422-8700 or email Jason.Hafer@genesishcc.com. Beth Jarrell can be contacted at Heritage of Dover by calling (302)735-8800.
Heritage at Milford and Heritage at Dover will welcome your questions and offer assistance by providing written information and tours of our facility. Just give us a call. Contact Jason Hafer at the Milford location at (302) 422-8700 or Beth Jarrell at Dover (302)735-8800. We look forward to seeing you.
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