The Centers for Medicare and Medicaid Services estimates that we – all those who have paid into the Medicare trust funds all our lives – are losing about $70 billion to criminal fraud each year. Seventy billion dollars in a program that is facing a number of challenges in the coming years, including rising health care costs and a growing number of people entering the program.
“That $70 billion in fraud would go a long way to extend the security of the Medicare program and even add more benefits,” said AARP New Hampshire fraud fighter Harold Moldoff. “All Medicare beneficiaries can be more vigilant. This is definitely an area where one person can make a difference.”
Some of waste is simple Medicare billing errors that need to be reported and corrected. Other waste is Medicare abuse when doctors or suppliers don’t follow good medical practices which results in unnecessary costs – unnecessary tests, unnecessary medical supplies or billing for name-brand drugs when generic drugs were dispensed.
And then there’s Medicare fraud when criminals file false claims for services not provided or equipment never received. Medicare numbers can even be stolen and sold to unscrupulous individuals!
“There are several things we can do to prevent Medicare fraud,” continued Moldoff. “Think of it as the three Rs: Record, Recognize and Report. Record on a calendar each medical appointment and reconcile to your Medicare and insurance statements. Recognize charges not incurred by you. And Report to the proper agencies those charges that are not yours.”
To help AARP members and others understand Medicare fraud, AARP New Hampshire fraud fighters are offering free presentations to community groups around the state. The 30- to 40-minute presentation will answer these questions:
- What are the top scams and how can you spot them?
- What are the red flags you should watch for?
- What is medical identity theft and how can you avoid it?
- Why should you only carry your Medicare card when you access the health care system, never sign blank insurance claim forms, and be wary of “free” medical services?
- How can carefully reviewing your Medicare Summary Notice cut down on costs?
To request a Medicare fraud presentation in your community – or get involved as a volunteer fraud fighter -- send an email to firstname.lastname@example.org .
“Information is power and helping people understand how to recognize and resist fraud is our main goal,” concluded Moldoff. “Medicare fraud costs everyone money and we all have a stake in stopping it in its tracks.”
Federal Trade Commission on Medical Identity Theft
CMS Medicare Fraud and Abuse Fact Sheet
Understanding Your Medicare Statement
New Hampshire Senior Medicare Patrol at ServiceLink Resource Centers
What You Can Learn from your Explanation of Benefits Statement
Archived AARP Webinar: Protect Yourself from Health Care Fraud
Medicare Interactive Counselor
AARP Health Record
[Photo courtesy of marsmet462]