You have several ways to report Medicare fraud, which along with errors and abuse cost Medicare billions of dollars each year.
If you suspect fraudulent activity, you can contact Medicare’s help line, the U.S. Department of Health and Human Services or your local State Health Insurance Assistance Program (SHIP). However, a good place to start is the Senior Medicare Patrol program, which the federal government finances but the states operate.
Identifying fraud isn’t always easy. Common scams include charging Medicare for services or supplies not provided, inflating costs of medical equipment and misrepresenting a diagnosis so Medicare will pay for unnecessary procedures and tests, some never performed.
Medicare identity theft is common, too. ID thieves offer seemingly free medical equipment so they can steal Medicare beneficiaries’ numbers and create fake claims.
Staying ahead of scams is easier said than done, but reviewing your Medicare summary notice, which is mailed to you every three months to identify services and supplies billed to Medicare, is a good way help you protect yourself.
Who do I contact about Medicare fraud?
If you suspect fraudulent activity on your Medicare account, have questions about suspicious charges or have been contacted by someone who tried to steal your Medicare number, you can report the problem in several ways.
Senior Medicare Patrol. The best first step is to contact the Senior Medicare Patrol (SMP). These organizations, which are financed by grants from the federal government, are available in every state, as well as the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands.
Local volunteers and staff help educate, detect and report Medicare fraud. Each state has a hotline for you to report suspected fraud and ask questions about possible scams. Volunteers and staff can help you gather evidence and guide you through the next steps. Find contact information for your state on the SMP resource center website or by calling 877-808-2468.
You can also report Medicare fraud directly to the following agencies, depending on the type of fraud. The volunteers can help you decide whom to contact and work with you to make the calls.