Medicare Fraud? Tips on How You Can Tell

Medicare and Medicaid services were created to help the elderly and or those with disabilities or certain other medical conditions be able to better afford medical coverage in order to pay for supplies, medical care, treatments, doctor’s visits and much more. This all seems like a good idea if it works the way it should and benefits those it is suppose to. Unfortunately though, there have been more and more cases of Medicare and Medicaid fraud and people are getting sneaky about how they get around the rules. Billing Medicare for services that were not received or provided can cost taxpayers millions of dollars each year and it also hurts those people that really need the medical care and services by causing them to pay more. To help avoid being a victim of Medicare Fraud use the following helpful detection tips. These tips include:

  • Be suspicious if a test is free and if a provider only needs your Medicare information for their records.
  •  Be aware if Medicare wants you to have a certain item or service.
  • Be cautious if the provider knows how to get Medicare to pay for an item or service
  • Be on the look out for provider that offer many tests at cheaper or discounted prices
  • Be careful if the equipment or service is free or you are offered a gift for the service


It is also important to know what services and equipment or medical supplies you are entitled to and report or question anything that seems out of the ordinary. As a general rule do not give out your Medicare health insurance claim number expect to your doctor or Medicare provider.

It is unfortunate that many people will try to scam those in need out of services and medical supplies for their own personal gain. It is good to know though that you can do something to help stop cases of fraud.

For additional information on Medicare fraud and prevention, you may visit:

If you or a loved one feel you have been a victim of Medicare fraud, please contact a  whistleblower attorney right away. They can help your case to be heard and make sure you get the care you deserve.

The “Dead Doctor” Scam: How Medicare and Medicaid Lost $70 Million In Fraudulent Claims

Most people envision Medicare or Medicaid fraud as a pharmacist billing for name brand prescriptions while dispersing the generic version, or a doctor inflating the cost of his services to bring in a few extra bucks.

Unfortunately, another type of Medicare and Medicaid fraud exists—and it’s one that took the Centers for Medicare and Medicaid Services (CMS) 7 years to put a stop to.

A subcommittee report issued by the Senate Homeland Security and Government Affairs Investigations Subcommittee on Tuesday revealed CMS has paid out more than $70 million between 2000 and 2007 for durable medical equipment that used the personal identification number of a deceased physician.

In response to the discovery, CMS deputy administrator, Herb Kuhn, assured government officials that the agency is working on a new system to stop fraudulent billing from “dead doctors”.  Apparently, the proposed system will require doctors to use a new National Provider Identifier, which will automatically cross check death records from the Social Security Administration database.

In addition, Kuhn told Subcommittee Chair Carl Levin (D-Mich.) that while the stolen funds have yet to be recovered, the agency plans to withhold future bonuses for companies found to be involved in the scam.

Withhold future bonuses?

I would hope that CMS would conduct an audit and prosecute every single company that participated in the dead doctor scam.  Patients are denied funding every day under Medicare and Medicaid because of budget constraints.  These scammers essentially stole from sick people who could have used that money to buy medicine, etc.

In addition, CMS should receive a complete administration overhaul for waiting so long to address this problem.  A few sources suggest that CMS may have known of the dead doctor scam as early as 2001—which is completely unacceptable in my opinion.

I think subcommittee ranking member Norm Colman (R-Minn) sums up the dead doctor scam the best: “We live in a high tech world…Surely we should have the capacity to figure out if doctors are dead.”

I totally agree.

Related Information:

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