Council on Aging Senior Guide 2012 - 114

COUNCIL ON AGING ORANGE COUNTY

How to Stop & Report Medicare Fraud
How to Stop Medicare Fraud Examine both the Medicare Summary Notice you receive from Medicare after your claims are paid and the Explanation of Benefits you receive from your Part D plan after purchasing prescription drugs. Did you receive all the services/prescriptions listed? Did your doctor order these services? Do the prescriptions listed match your prescriptions? Are the dates of the services/prescriptions correct? Are the dollar amounts shown the same as those on your bill? Protect your Medicare card number as well as your Social Security number. Don’t give these numbers to anyone over the phone or in person, unless you initiated the conversation, you know the person, and you write down their name, number and title. Don’t leave your Medicare number in a phone message. Don’t accept any offer of “free” services or supplies in return for your Medicare number. Don’t let anyone convince you to see a doctor for a service you don’t need. Don’t accept offers of money, free food or gifts for medical care. Don’t accept medical supplies from door-to-door salespeople. Don’t be influenced by media advertisements concerning your health. Their main purpose is to raise money, and they don’t have your best interests at heart. Avoid scams that include incentives like “It’s free!” or “We know how to bill Medicare.” Educate yourself about Medicare. Know your rights as well as what type of medical care providers can and cannot offer. Ask questions. You have a right to know about your medical care. How to Report Suspected Medicare Fraud Follow the steps below if you think Medicare should not have paid for an item listed on your Medicare Summary Notice (MSN), you shouldn’t have been charged for drugs listed on your Part D Explanation of Benefits (EOB) or you suspect Medicare fraud. Be sure to have your MSN and/or Part D EOB with you when you call so you can provide as much information as possible about the item in question.
114
Senior Guide OC 2012

Call the health care provider listed on the MSN or Part D EOB and inquire about the questionable item. In many cases, it may be the result of a billing error, which can easily be corrected. If your question is not resolved and you still think the charges are fraudulent, call the Senior Medicare Patrol at 1-855-613-7080. We will ask you for the pertinent facts and review your concerns. If appropriate, we’ll help forward your case to the proper fraud investigation agency. You can also contact the U.S. Department of Health and Human Services’ Office of Inspector General (1-800447-8477). Your SMP counselor will help you determine if this step is necessary. Learn More If your group or organization would like a free presentation about Medicare fraud and how to prevent it, contact a Senior Medicare Patrol counselor at your local HICAP office online or at 1-800-434-0222. Our SMP staff also provides Medicare fraud trainings designed for professionals serving Medicare beneficiaries. See our Education section for details and to book a workshop. You can also visit StopMedicareFraud.gov for more information what’s happening nationwide on the fraud front and additional educational resources.
Aging and Disability Resource Connection | 800-510-2020 | www.adrcoc.org

http://www.StopMedicareFraud.gov http://www.adrcoc.org

Council on Aging Senior Guide 2012

Table of Contents for the Digital Edition of Council on Aging Senior Guide 2012