How Medicare Fraud Hurts Older Adults, and Solutions to Prevent and Address Harm

The serious and prevalent crime of Medicare fraud has significant consequences for people enrolled in the program.

Fraud can block access to life-saving care, create erroneous out-of-pocket costs, and cause stress from having to solve billing and enrollment problems. While most entities bill legitimately, perpetrators generally include health care providers, suppliers, and other entities with authority to bill and receive payment from Medicare. This fact sheet discusses how Medicare fraud hurts beneficiaries and provides recommendations for both remedying and preventing such harm. Read the full report.    

Key Takeaways:

• False claims, stolen Medicare IDs, and fabricated medical records can block or delay access to needed medical care for beneficiaries.
• The financial impact of Medicare fraud extends to all Medicare beneficiaries and taxpayers, with increased costs fueling higher premiums, deductibles, and taxpayer expenses.
• As federal agencies continue to ramp up efforts to prevent fraud, such efforts should include a focus on the beneficiary, such as by streamlining recovery for fraud victims, expanding fraud education, and ensuring that anti-fraud measures do not create new barriers to care for enrollees.