Medicare fraud happens when Medicare is billed for services or supplies you never received. Medicare abuse happens when doctors or suppliers don’t follow good medical practices which lead to unnecessary costs, improper payments, or services that are not medically necessary.
How can you prevent Medicare Fraud and Abuse?
List of Dos:
√ Do protect your Medicare number and your Social Security number. Treat your Medicare card like you treat your credit cards.
√ Do remember that nothing is truly “FREE.” Any free offer for medical care is NOT free.
√ Do ask questions. You have a right to know any and all answers related to your medical care.
√ Do educate yourself about Medicare. Know your rights and what a provider can and cannot bill to Medicare.
√ Do use a calendar to records all of your doctor’s appointments, tests, or x-rays. Then compare this calendar to your Medicare statements carefully to make sure each service listed and the details are correct. (If you spend time in a hospital, made sure the admission date, discharge date, and diagnosis on your bill are correct.)
√ Do be wary of providers who tell you that the item or service is usually not covered but they “know how to bill Medicare.”
√ Do make sure you understand how a plan works before you join.
√ Do check your pills before you leave the pharmacy to make sure you received the correct medication, that it is the correct amount, and whether the medication is generic or a name brand product. (If you do not receive the full amount, report the problem to the pharmacist.)
√ Do report suspected instances of fraud.
List of Don’ts:
Χ Don’t allow anyone (except your doctor or other Medicare provider) to review your medical records or recommend services.
Χ Don’t contact your doctor to request a service you do not need.
Χ Don’t let anyone persuade you to see a doctor for care or services you do not need.
Χ Don’t accept medical supplies from a door-to-door salesman. Medicare and Medicaid DO NOT send representatives to your home to sell products or services.
Χ Don’t be influenced by certain medical advertising about your health. Many television and radio ads don’t have your best interest at heart.
Χ Don’t give your Medicare card, Medicare number, Social Security card, or Social Security number to ANYONE except your doctor or Medicare provider.
For more information, visit the Area Agency on Aging of Central Texas at: http://www.centexaaa.com/