What is Medicare and Medicaid Fraud?

Fraud occurs when individuals, providers, or organizations deliberately deceive others in order to gain some sort of unauthorized benefit or service. Medicare and Medicaid fraud generally involves deliberately billing for services that were not received or billing for a service at a higher rate than is actually justified.

What is Medicare and Medicaid Abuse?

Health Care Abuse occurs when providers supply services or products that are not medically necessary or that do not meet professional standard.

Examples of Fraud and Abuse

• Billing Medicare for services not received or needed
• Providers representing themselves as being part of, or endorsed by the federal or state government
• Overcharging for services and equipment/Incorrect billing “upcoding”
• Using someone else’s Medicare Card
• False claims
• Offering free services or equipment and then charging Medicare for services

Identity Theft

You should consider buying a locked file cabinet to store important documents at home, especially if you live with roommates or employ outside help. At work, ask your employer whether your personnel records are kept in a secure location, since these contain personal and confidential information – social security number, address, banking information – that can be used for many fraudulent purposes.

Dumpster Diving

You don’t have to be a celebrity to be a target of “dumpster divers” who comb people’s trash looking for personal information. You should shred all transaction or other personal records you don’t need to keep. Be especially aware of pre-approved credit card offers, which arrive at some people’s doorsteps in a steady stream but should not be simply tossed into the trash. To avoid getting unsolicited offers for credit cards, the major credit bureaus will help get you removed from marketing lists by calling 888-567-8688; they will ask for your social security number for verification.

Protect Your Incoming and Outgoing Mail

Identity thieves can target both your incoming and outgoing mail using the information to open new accounts, hijack existing ones, or assume your identity for other purposes. You should send outgoing checks through public or post office mailboxes, not the one at your home. And be sure to stop mail delivery if you are going on vacation. Be aware that some identity thieves will put in a change of address to divert your mail. And it’s important to remember that the mail you receive may be part of a scam. For example, some thieves have started sending out a very real looking IRS form that asks for sensitive information. You should contact the Internal Revenue Service and your post office if you receive any of the examples listed below.

Examples of Mail Fraud

• Lottery winnings notification
• IRS owes you money scams
• IRS notification of new Social Security number or Medicare number
• Stimulus payment to your bank account
• Credit Card and Bank Notification

Protect Your Personal Information

Often used to store financial records, tax returns, photos and other personal information, your computer is a treasure trove for an identity thief. You should update your virus software regularly and not open unfamiliar e-mail attachments, since viruses can create backdoors for hackers to steal information from your PC.

Also, make sure your browser, such as Internet Explorer or Firefox, is updated with the latest encryption software so that information you send over the Internet is secure.

When giving an account number online, the URL on the address bar at the top of your screen should read “https” or shttp,” not “http,” and an icon at the bottom of your screen may change from a broken key to complete one, or an open lock to one that is closed. This means the information is being transmitted securely.

You should next make sure the company is safeguarding the info by storing it in a secure database, information which should be available on their Web site.

Before doing business with an unfamiliar company, check with your local consumer protection agency and the Better Business Bureau to see if they have been reported. Some scammers set up fake Web sites designed to steal your personal information. If an offer seems too good to be true, it probably is.

Passwords you use to access online accounts, including e-mail, should be treated with as much security as the one for your ATM. You should always password protect your laptop, and might decide against using it to store financial information.

Finally, if you are getting rid of a computer, be aware that information you think has been deleted can still be recoverable, and you need to use a “wipe” program to make sure it is really clean.

Protect Your Name

Up to 2.5 million Americans may be victimized by identity bandits each year, the Justice Department says, and it costs the average victim more than $1,000 in expenses to cope with the damage to their accounts and reputation. The average loss is $45,000 per victim.

To help you stay one step ahead of identity thieves you should check your credit report once a year; follow up on bills that don’t arrive on time (they may be going to a thief) and call the Federal Trade Commission at 1-877-ID-THEFT (1-877-348-4338) to report suspected cases.

Free Credit Report

www.annualcreditreport.com
1-877-322-8228

Report ID Theft

Federal Trade Commission
1-877-438-4338

Identity Theft Clearing House
600 Pennsylvania Ave, NW
Washington, DC 20580

Telemarketing / Door-to-Door Sales

Generally, you should only conduct transactions involving personal information if you are the person who initiated the call. You should also be wary of callers who say they are with the government or that information is needed in order for you to collect a prize. There’s a booming “information gathering industry” in America, and companies sometimes employ a method known as “pretexting,” in which they contact you or your family to gain personal information through deception. In most cases this is legal, although the information can then be passed on to someone who uses it to commit a crime, such as identity theft or stalking.