Medicare fraud is when service providers bill Medicare for
services that are never given. This also includes billing Medicare for
equipment that was never received by the patient, or equipment that has
been returned by a patient. It also includes someone using another
person’s Medicare card to get treatment or supplies. You should be
aware that there are different techniques used to abuse Medicare.
One
commonly used is charging a co-payment for tests that Medicare provides
for free. These tests are often preventative tests such as PAP smears,
PSA tests or flu shots. Another indication of Medicare fraud is if the
provider consistently waives fees without checking your ability to pay,
advertise free consultations, pressure you into getting high priced
equipment or tests, or use door-to-door selling tactics.
Some of the most recent scams uncovered by Medicare include claiming a
hip guard device used to prevent damage as a treatment for hip damage,
listing respiratory failure as sleep apnea, billing for sleep studies
and heart tests that were never performed, and billing for services
that are not needed.
Medicare is currently trying to prevent fraud and abuse by better
educating service providers and people on Medicare. They have also set
up a reward program where you can receive a reward for reporting
information that leads to the recovery of funds that have been taken by
fraud or abuse. They are also hiring anti-fraud contractors. In pilot
programs they have found that the contractors are able to save Medicare
$23 for every dollar they spent in hiring the contractors.
By: LEON fILER Posted: Oct 28 2005 02:19:46 PM