Medicare and its 65 million beneficiaries are susceptible to an increasing number of fraud activities and scammers, costing the program billions of dollars each year. Scammers’ primary aim is to defraud Medicare itself; however, their schemes often rely on targeting beneficiaries directly, stealing their identities or enlisting them as unwitting accomplices.
Medicare fraud usually involves rogue health care providers or medical suppliers who bill the program for services, equipment or medication they don’t provide or otherwise inflate the cost of those items. Some will even falsify patients’ diagnoses to justify unnecessary tests, surgeries and other procedures or write prescriptions for patients they’ve never examined. Other provider or supplier Medicare scams use genuine patient information, sometimes obtained through identity theft, to create fake claims.
During the coronavirus pandemic, scammers targeted beneficiaries with offers of free COVID-19 tests in exchange for their Medicare number or other personal information, according to the U.S. Department of Health and Human Services’ Office of Inspector General. The scammers use the data for medical identity theft, and victims can end up bearing the cost of an unapproved test or treatment.
Common Medicare scams
- Disreputable home health care agencies try to sign people up for services that Medicare pays for but that patients never receive.
- Identity thieves call Medicare beneficiaries and offer to send them a new Medicare card made of heavy-duty plastic or containing a chip, like a credit card. Instead, they steal the person’s Medicare number and file fake claims in their name. Medicare doesn’t offer a chip card, and you can order or download a replacement Medicare card at any time from your online Medicare account.
- Telemarketers call beneficiaries with offers of free state-of-the-art braces to relieve joint pain. Instead, consumers receive ordinary ankle or knee wraps or nothing at all, but Medicare gets a bill for thousands of dollars.
- Unscrupulous clinics write phony prescriptions or order unnecessary tests and procedures to steal from Medicare. Another ploy: providing treatment that Medicare doesn’t pay for and then billing it as a different, covered service.