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How to prevent Medicare fraud

  • LINDA KOEHLER/TIMES NEWS Kathy McIntosh talks to members of Western Pocono Women's Club about Medicare fraud.
    LINDA KOEHLER/TIMES NEWS Kathy McIntosh talks to members of Western Pocono Women's Club about Medicare fraud.
Published July 27. 2012 05:01PM

"Never ever give your Medicare ID number to anyone," said Kathy McIntosh of PA Senior Medicare Patrol. She was the speaker at the Western Pocono Women's Club and the topic was Medicare Fraud.

"Medicare will never call you or come to your door. So you should never give your Medicare ID number to anyone who asks," she said.

"If anyone calls you or comes to your home and offers you something from Medicare for free but first you have to give them your ID number, remember this, Medicare gives nothing away free."

Over $60 billion a year is paid out fraudulently. McIntosh said there are things we can do to prevent fraud. One is to always study your bill or statement.

Be suspicious of anyone who offers you free medical equipment or services and then requests your Medicare number. If it's free, they do not need your number.

Do not let anyone borrow or pay to use your Medicare ID card or your identity. It's illegal, and it's not worth it.

Some examples of possible Medicare fraud include:

*health care provider bills Medicare for services you never received.

*a supplier bills Medicare for equipment you never got.

*someone uses another person's Medicare card to get medical care, supplies, or equipment.

*someone bills Medicare for home medical equipment after it has been returned.

*a company offers a Medicare drug plan that has not been approved by Medicare.

*a company uses false information to mislead you into joining a Medicare plan.

Medicare fraud affects every American. Waste, fraud and abuse take critical resources out of our health care system, and contribute to the rising cost of health care for all Americans.

Eliminating fraud will cut costs for families, businesses and the federal government and increase the quality of services for those who need care.

Be suspicious of doctors, health care providers, or suppliers if:

*equipment or service is offered free and you are then asked for your Medicare number for "record keeping purposes".

*Medicare wants you to have the item or service in exchange for your Medicare number.

*they tell you how to get Medicare to pay for the item or service and all that is needed is your Medicare number.

*you are told the more tests provided, the cheaper the tests become in the future.

*they want to charge copayments without checking on your ability to pay.

*they advertise "free" consultations to people with Medicare.

*they call or visit you and say they represent Medicare or the Federal government.

*they use telephone or door-to-door selling techniques.

*they use pressure or scare tactics to sell you expensive medical services or diagnostic tests.

*they bill Medicare for services you never received or a diagnosis you do not have.

*they offer non-medical transportation or housekeeping as Medicare-approved services.

*they bill home health services for patients who are not confined to their home, or for patients who still drive a car.

*they bill Medicare for medical equipment for people in nursing homes.

*they bill Medicare for tests you received as a hospital inpatient or within 72 hours of admission or discharge.

*they bill Medicare for a power wheelchair or schooter when you don't meet Medicare's qualifications.

If your Medicare card is lost or stolen, report it right away. Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) for a replacement.

If you get benefits from the Railroad Retirement Board, call 1-877-772-5772.

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