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Health Care Fraud & You

How to Protect Yourself From Health Care Scams

 Darren Greenwood/Aurora

Although law enforcement officials use sophisticated investigative practices to reveal the many ways health care fraud happens, they can’t fight these crimes alone.

Who pays for health care fraud? We all do.

Thieves and scam artists are driving up your insurance premiums and other health care costs. They’re picking your pockets because they think you don’t know enough to fight back. It's time for you to get the facts and protect yourself against fraud.

Scams and solutions

Criminals use the news headlines, such as those about the health care law, as inspiration for clever sales pitches that defraud the public and pad their own pockets. Law enforcement officials have spotted the following scams:

• A television commercial urging people to call a toll-free number to sign up for "the new government insurance" during a “limited enrollment period.”

• Scammers who claim to be with the government going door-to-door to sell fake medical discount plans.

• Telemarketers seeking personal information in order to, they say, issue new Medicare cards as required by the health care law.

Each of these pitches is a fraud. But scam artists are slick, so it's hard to predict all the ways in which they'll attempt to twist the news for their own profit.

Although law enforcement officials use sophisticated investigative practices to reveal the many ways health care fraud happens, they can’t fight these crimes alone. You can help put these thieves out of business by protecting your insurance identification number, reviewing your bills and recognizing the signs of possible fraud.

For instance, medical identity theft occurs when someone steals your health insurance, Medicare, Medicaid or Social Security numbers. To prevent identity theft:

• Guard your health insurance, Medicare, Medicaid and Social Security numbers in the same way you protect your credit card numbers. Never give these numbers to a stranger on the phone, in an e-mail or on a website.

• Don't carry your health insurance card all the time. Just put the card in your purse or wallet when you know you might need to use it at a doctor’s appointment or pharmacy. Or carry a photocopy of the card with all the identification numbers except the last four digits blacked out.

• Decline all offers of free medical equipment, health services, groceries or gift cards that require you to provide your insurance information. If the offer is truly free, your ID numbers aren't needed.

• Ignore people who try to sell you a new insurance policy by saying they are government officials, or that the plan they're offering is approved by the government.

• Government officials will not be calling you about any health insurance programs or any part of your Medicare coverage.

Report to authorities anyone who claims that they are "with the government" and wants your money or your personal information. Ignore anyone who uses the sales pitch that "you have been preapproved" for insurance because of the health care law.

Another way to spot fraud is by examining your health insurance Explanation of Benefits or your Medicare Summary Notice.

• Routinely review the statements you receive from your doctor, hospital, pharmacy, insurance company or Medicare in order to identify mistakes.

• Look through the statements for medical services you didn’t receive, repeat billings for the same procedures or claims for services your doctor, hospital or pharmacist never provided.

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