Senior Medicare Patrol Helps Fight Health Care Fraud; You Can Too

Health care costs are on the rise, and one reason is health care fraud. Fraud is a major contributing factor to rising health care costs and can also put your health and well-being at risk.

A recent article in USA Today featured Senior Medicare Patrols. These are teams of volunteers who help the Department of Health and Human Services educate Medicare beneficiaries about health care fraud.

An excerpt:

Officials believe that if older Americans — including the growing crop of eligible Baby Boomers — know how to spot errors and fraud, “more criminals will be put in jail where they belong,” Barbara Dieker told a group of volunteers recently. Dieker directs the Department of Health and Human Services’ Office of Elder Rights, which oversees the Senior Medicare Patrols.

Funding for the Senior Medicare Patrols increased from $9 million last year to $18 million this year in the form of Administration on Aging grants that target fraud-rich regions, including Florida, California, New York and Michigan.

What is Health Care Fraud?

There are many types of health care fraud. Examples range from a patient intentionally using someone else’s health insurance ID card, to a doctor billing an insurance company for services that were not needed — or not performed.

Fraud can adversely affect your health if someone uses your health coverage ID to obtain medical treatment that he or she is not entitled to. The fraudulent data in your medical records could result in your being denied life insurance, based on a condition you don’t have. Or, your doctor might prescribe a dangerous medication or treatment based on test results for someone who fraudulently used your ID.

How to Protect Yourself?

How can you help to expose and prevent fraud that might affect your well-being or your coverage? Always check your bills and EOBs to verify that the services listed are services you received. Call your doctor’s office to question anything that seems to be wrong. It’s probably just a mistake, but you need to make sure someone else isn’t using your coverage plan ID information to steal your benefits.

If you suspect fraud, please report it immediately to your health insurance plan. Read more about anti-fraud efforts in Michigan, including some success stories in the case files.

Photo credit: Pahz

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