MEDICARE FRAUD

Don’t be a Victim

Since 1997, the US Administration on Aging has funded Senior Medicare Patrol (SMP) programs in all fifty states and US territories. The programs recruit and train retired professionals to teach Medicare beneficiaries how to recognize and report possible healthcare fraud in the Medicare and Medicaid systems. SMP programs also work to resolve beneficiary complaints of potential fraud, waste and abuse. Working alongside state and national fraud control and consumer protection entities, including Medicare contractors, state Medicaid fraud control units, the Centers for Medicare and Medicaid Services and the US Office of Inspector General, SMP programs have been instrumental in returning millions of dollars to the Medicare system.

The SMP message is simple. Protect, detect and report. Protect your Medicare benefits and the Medicare systems from dishonest healthcare providers by protecting your Medicare number. Do not give it out to people you don’t know. Don’t give it to anyone on the phone. Say “no” to offers of free medical equipment. Remember that your Medicare card number can be more valuable than any credit card, if the person who gets your number uses it to bill Medicare for services and products you have not received.

 

Finally, report any suspicious activity. You could be uncovering a major scam, such as the ones mentioned above. Please contact us using the information listed below for more details or if you suspect Medicare fraud, waste, or abuse.

Georgia Senior Medicare Patrol

877-272-8720

or visit www.stopmedicarefraud.org

MEDICARE FRAUD

Fraud Alert
for Medicare Recipients with Diabetes

Criminals who plot to defraud Medicare have a new target: people with diabetes. Although the precise method may vary, the scheme generally involves a caller pretending to be from the Government, a diabetes association, or even Medicare. The caller offers "free" diabetic supplies, such as glucose meters, diabetic test strips, or lancets.

 

The call is a scam.

If you receive such a call, Senior Medicare Patrol (SMP) recommends the following actions:

 

1. Protect Your Medicare and Other Personal Information

Do not provide your Medicare number or other personal information. Be suspicious of anyone who offers free items or services and then asks for your Medicare or financial information. These calls are not coming from Medicare, diabetes associations, or other similar organizations. While the caller says the items are "free," the items are still billed to Medicare.

 

2. Check Your Medicare Summary Notice

Check your Medicare Summary Notice and other medical information to see if Medicare was charged for items you did not order or did not receive. Also, check for supplies items that may have been incorrectly billed multiple times. Report any irregular activity to your health care provider and the SMP Hotline at 1-877-272-8720.

 

3. Do Not Accept Items That You Did Not Order

You are under no obligation to accept items that you did not order. Instead, you should refuse the delivery and/or return to the sender. Keep a record of the sender's name and the date you returned the item(s) to help SMP catch any future illegal billing.

 

Georgia Senior Medicare Patrol is a non-profit organization funded in part through a grant from the US Administration for Community Living. Please contact Georgia Senior Medicare Patrol at
1-877-272-8720 or visit www.stopmedicarefraud.org for more information on how you can stop Medicare fraud.

Georgia Senior Medicare Patrol

877-272-8720

or visit www.stopmedicarefraud.org

MEDICARE FRAUD

Genetic Testing

Georgia Senior Medicare Patrol (SMP) recently became aware of a scheme involving genetic testing laboratories conducting fraudulent and unnecessary tests on Medicare beneficiaries. These schemes are being conducted at senior centers, meal sites, community centers, and senior housing facilities.

The laboratory representative offers to host an ice cream social or other event for the center and will also provide free genetic or DNA testing to the Medicare beneficiaries at the event.

Laboratory representatives collect the beneficiary’s Medicare number, take cheek swabs of Medicare beneficiary and then submit claims to Medicare for payment. In some cases, they offer to send the testing kits directly to the beneficiary’s home address.

Things to remember about genetic testing:
 

• Medicare will only pay for medically necessary genetic testing
 

• Genetic testing is very expensive and only needed under very specific circumstances
 

• Medicare requires an order from a physician or qualified health care practitioner
 

• Medicare requires a signed beneficiary consent form prior to paying for genetic testing

 

To learn more or if you have been a victim of this scam, please call Senior Medicare Patrol at 1-877-272-8720
or visit www.stopmedicarefraud.org

 

This alert has been brought to you by Georgia Senior Medicare Patrol— A non-profit organization funded in part through a grant from the
US Administration for Community Living.

Georgia Senior Medicare Patrol

877-272-8720

or visit www.stopmedicarefraud.org

MEDICARE FRAUD

Medicare and Ambulance Transportation

Senior Medicare Patrol would like to share important information with you regarding your health care. Here are some things you should know if you were to need ambulance transportation.

 

How the Scam Works

  • Ambulance Transportation is only covered when other transportation would be dangerous to your health.
     

  • You have the right to choose the ambulance service.

  • Non-emergency transport can be very costly to you.
     

  • By signing the Advanced Beneficiary Notice anything not covered by Medicare will be billed to YOU.
     

  • Check your Medicare Summary Notice. This statement from Medicare lists everything that Medicare paid for you. Look at the Part B section. Make sure Medicare only paid for services you actually received. Call us if you need help reading your statement. We can help you make sure there are no mistakes.

 

Senior Medicare Patrol
887-272-8720 or www.stopmedicarefraud.org. Our services are free.

 

This project was supported, in part by a grant (Nos. 90MP194-01-01, 90MP0196-01-00 and 90MP195-01-04), from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.

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