Q. I’m afraid I may be a victim of Medicare fraud. What should I do? Can I get a different Medicare number to stop the fraud?
A. Medicare identity theft is a serious and growing problem. With 46 million beneficiaries who expend $375 billion annually, the program is so large and complex it makes a prefect target for theft.
The Affordable Care Act has created the Health Care Fraud Prevention and Enforcement Action Team, which has increased the number of charged fraud cases by 75 percent and returned $10.7 billion to the Medicare Trust Fund since 2009.
This is a good start, and HEAT will continue to try to catch those who defraud Medicare. But it is up to each Medicare beneficiary to do their part to stop Medicare fraud before it happens. Medicare fraud has many scenarios. You may feel you have been charged for a treatment you didn’t have, especially if a location you haven’t been to is listed, or someone calls to say they need your Medicare number for a free service. You may have just been a victim of Medicare fraud.
Even if you have been a victim of Medicare fraud, you will not be issued a new Medicare or Social Security number, so it is critical you notify Medicare at 800-HHS-TIPS (800-447-8477) to make a Medicare worker aware of any concerns. If you fail to notify Medicare, you may find false claims being filed under your number and this can impact you with staggering medical bills, maxed-out benefits and compromised medical history records.
Before you call Medicare, review with your doctor your concerns, in case the situation is a simple billing error. Be sure to have the Medicare Summary Notice in front of you when calling Medicare, so you can give them the information needed.
The Senior Medicare Patrol is available to help victims of Medicare fraud. It can be a real help in deciding whether it is fraud or just a mistake. Call 800-551-3191, or in Yellowstone County, 259-5212, for a referral to a local SMP worker.
Send questions about Medicare or Medicaid to: SHIP Program, c/o Yellowstone Co. Council on Aging, 1505 Avenue D, Billings, MT 59102 or email@example.com.
Questions are answered by the State Health Insurance Assistance Program, an objective, nonprofit counseling, assistance and advocacy service sponsored by DPHHS of Montana and Centers for Medicare & Medicaid Services.