How Does Medicare Fraud Affect You?

It is shocking to know that over $60 billion is needlessly spent each year by the government and taxpayers because of fraud within the Medicare system. The system is strained by these costs, and as as result the quality of service can be horribly affected.

Medicare was created to provide U.S. citizens over the age of 65 and persons with disabilities with acceptable health coverage for medical supplies, procedures and prescriptions. Everyone contributes to the Medicare program through their income taxes over their working lifetime.

The most common type of fraud inside the Medicare system is phantom billing. This is when a person or organization willfully charges the Medicare system for equipment or procedures that are unneeded and unused. This is happening on a daily basis in all of the 52 states.

It continues to largely go undetected because of the sheer amount of regular requests for reimbursement. Not all claims can be investigated, and the fraudulent parties are relying on that fact. For example, if you were to require a wheelchair for your medical needs, you may not receive the same one that is billed to Medicare. Often what happens is that the system will be charged for a more expensive wheelchair and you will only receive the most basic model. The effect that this type of blatant fraudulent behavior has on the system can be devastating. Because of the costs going out, the actual services that citizens are receiving are lower in quality. There have been many unfortunate cuts to services and coverage that can negatively affect thousands of patients in need. By stealing from the system that is meant to help its citizens, the level of service available has suffered horribly.

Private citizens can join the fight to try to eliminate Medicare fraud. When you receive your monthly summary billing from Medicare, take close notice of all of the charges and fees that are listed. If you see anything that looks suspicious it is important that you make note of it and call your doctor.

Talking to your doctor should always be the first move that you make when you find an error. They will be able to let you know right away if the error is possibly just clerical and can be corrected easily. If the error is possibly fraudulent, your doctor’s office will explain to you how to anonymously report Medicare fraud to the proper authorities.

If you are concerned about a billing issue with your Medicare, it is a good idea to gather as much information as you can before you make an official claim. Go back several months in your billing summaries and check for any other inconsistencies. Your doctor’s office should also be able to give your copies of their original billings that you can add to your file.

Medicare was created to help serve and protect our most valued citizens. If there is a problem or you suspect fraud in your Medicare billing, don’t hesitate to do your duty and report it.


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