What Medicare Fraud Means To You

Wednesday, May 29, 2013
Americans spend decades protecting their Social Security numbers - not carrying their cards in their wallets, carefully parsing who they share the number with, monitoring their Social Security statements for signs of fraud. So many people are shocked when they first enroll in Medicare only to find that the card they must carry and show in order to obtain health care services bears their Social Security Number.

With few exceptions, Medicare identity card numbers are the carrier's Social Security number - a fact which has spurred an alarming volume of Medicare fraud and identity theft cases. Enterprising identity thieves can use Social Security theft to open new credit accounts and commit a range of other types of theft and fraud.

The financial impact of Medicare fraud is far-reaching, affecting not only individuals but the American economy as well. Since its founding in 2009, the federal Medicare Fraud Strike Force has nabbed nearly 600 people connected with almost $2 billion in fraudulent billings, according to the U.S. Department of Health and Human Services. A May operation netted 89 suspects, including doctors, nurses and other licensed health care professionals, for schemes that involved about $223 million in faked billings.

If you'll soon be enrolling in Medicare, or if you're already on Medicare, it's essential to take steps to catch fraud and prevent identity theft. Preventive actions include:

• Present your Medicare card only on an initial visit to a new health care provider. For subsequent visits, take a photo copy of the card and trim it to remove the last four digits of your number, so that if they copy is lost or stolen, your entire number won't be compromised.

• Record the dates of doctor visits and exams, and what services you received. Compare saved receipts and your records to your Medicare claims statement to ensure Medicare wasn't billed for services, medications or other items you didn't receive.

• If you spot an error on your statement and the provider can't explain or clear up the discrepancy, report your suspicions to Medicare at (800) MEDICARE (63342273).

• Monitor your credit report and financial accounts regularly. Often, these are the first places identity theft and fraud will show up. Catching crime quickly may help mitigate the damage.

• Never lend your Medicare card to someone else to obtain services or medications. It's against the law, and could put you at risk of both identity theft and criminal prosecution.

AARP's Ms. Medicare blog notes that many consumer groups and government agencies have advocated changing Medicare identification so that it no longer uses Social Security Numbers. However the cost and logistics - at least $800 million over a five-year period to update 47 million Medicare card holders, and billions of doctor's office, hospital and other records - make it unlikely a change will occur any time soon, AARP says.

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