How to report Medicare fraud? The ultimate guide to reporting waste, abuse, and more

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Medicare fraud isn’t just a legal issue, it’s a serious threat to the integrity of our healthcare system and the safety of millions of beneficiaries.

Every year, deceptive practices cost the government billions of dollars and compromise the quality of patient care.

Why Medicare fraud and abuse matter more than you think

With Medicare’s role expanding as more people age into the program, safeguarding it from fraud and abuse has never been more critical.

While most medical professionals act ethically and provide appropriate care, the trust placed in them by patients and Medicare makes the system vulnerable to exploitation.

Fraud can take many forms, from falsifying claims to billing for services that were never delivered.

Abuse, while sometimes less deliberate, still leads to unnecessary costs and substandard care.

Whether intentional or not, both have serious consequences, and both must be addressed.

So, how can you help protect the Medicare system?

It starts with knowing what to look for.

Fraud includes knowingly submitting false claims, offering or receiving illegal kickbacks, or ordering services that aren’t medically necessary.

Abuse might involve overcharging for services or using incorrect billing codes to increase reimbursement.

Even failing to report no-show appointments that are still billed to Medicare can be a red flag.

Patients are not just potential victims, they’re also crucial in preventing fraud.

Always compare your calendar with the statements you receive to ensure accuracy.

Protect your Medicare card like you would a credit card, and never give your Medicare or Social Security numbers to anyone except trusted providers.

Medicare will never call to sell you anything or show up at your door unannounced.

If something feels off, like a charge for a service you didn’t receive or a suspicious phone call, it’s important to act.

Start by contacting your provider to clarify the issue.

If the concern isn’t resolved or seems intentional, report it.

You can call 1-800-HHS-TIPS (1-800-447-8477) to report suspected fraud or abuse confidentially.

This news was originally published on this post .

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