Billions lost in both Medicare, Medicaid fraud and waste
In society today, most retired persons take comfort in knowing that medical services will be there when needed, thanks to Medicare and Medicaid.
It should concern all of us that because of unscrupulous practices of a small proportion of health-care providers, Medicare and Medicaid are being drained of valuable resources.
In 1998 alone, Medicare lost nearly $13 billion to fraudulent or unnecessary claims.
This problem affects all Americans. It affects those who depend on Medicare and Medicaid by diminishing the quality of the treatment they receive. It affects caregivers by decreasing the funding available for important programs. And it affects everyone who pays taxes by wasting billions of tax dollars.
Most health care professionals are honest, trustworthy and responsible.
However, fraud occurs when an individual or organization deliberately deceives others in order to gain some sort of unauthorized benefit.
Fraud generally involves billing for services that were never rendered or billing for a service at a higher rate than is actually justified.
Health-care waste and abuse occurs when providers supply services or products that are medically unnecessary or that do not meet professional standards.
What can you do to combat waste, fraud and abuse? First, treat your Medicare number as you would your credit card number.
Handle it with care.
Second, read your explanation of benefits statements carefully.
Call your provider or Medicare insurance company for an explanation or clarification of unusual or questionable Medicare charges.
Finally, if you have called your provider and your Medicare insurance carrier and continue to have questions, call the Medicare Fraud Hotline at (800) 447-8477.
Together we can reduce Medicare and Medicaid fraud, waste and abuse and keep these valuable programs financially stable.
For more information about Medicare fraud, or about the Medicare program itself, call (800) 633-4227, or visit the Medicare website at www.medicare.gov.
This article was written by Gene Moreno, Social Security Manger in the agency’s Prescott office.