National Report Medicare Fraud Day: September 12th

Every year, September 12 is National Report Medicare Fraud Day. This day helps people learn about Medicare fraud and it encourages everyone to report any suspicious activities they see. This day serves as a reminder of the importance of safeguarding the integrity of the Medicare system, which provides vital health coverage to millions of Americans, particularly seniors and individuals with disabilities.

What is Medicare Fraud?

Medicare fraud occurs when individuals or companies deceive the Medicare system. They do this to receive money or benefits they are not entitled to. This fraudulent activity can take many forms, including:

Billing for Services Not Provided: Submitting claims for medical services, tests, or equipment that were never actually provided to the patient.

Upcoding: Inflating the seriousness of a diagnosis or the complexity of a procedure to receive higher reimbursement than is warranted.

Double Billing: Submitting multiple claims for the same service or procedure.

Kickbacks: Offering or receiving illegal payments to influence decisions on patient referrals, treatments, or services.

Identity Theft: Using a person's Medicare information to file false claims.

Medicare fraud is not just a victimless crime; it results in significant financial losses for the Medicare system—costing taxpayers billions of dollars each year. These losses can lead to increased healthcare costs and potential reductions in benefits or services.

The History of National Report Medicare Fraud Day

National Report Medicare Fraud Day was established by the Senior Medicare Patrol (SMP) and other advocacy groups in response to the growing incidence of fraud within the Medicare system. It aims to encourage vigilance and proactive reporting by beneficiaries, caregivers, healthcare providers, and the general public.

The choice of September 12th for this observance is symbolic, reflecting the need for year-round vigilance. It is strategically placed after Labor Day, a time when people may be thinking about health benefits and financial planning for the future.

Why Reporting Medicare Fraud is Important

Reporting Medicare fraud is crucial for several reasons:

Protecting Taxpayer Dollars: Medicare is funded by taxpayer contributions, and fraudulent activities drain resources that could otherwise be used to improve care and benefits for legitimate beneficiaries.

Ensuring Quality Care: Fraudulent practices often compromise the quality of care. For example, when providers bill for unnecessary services, patients may be exposed to needless procedures or medications, which can be harmful.

Preventing Identity Theft: Reporting suspicious activities can help protect against identity theft. Scammers often steal Medicare numbers to bill the system for services the beneficiary never received.

Supporting System Integrity: Reporting fraud helps maintain the integrity of the Medicare program, ensuring that it remains a reliable source of healthcare coverage for future generations.

How to Spot and Report Medicare Fraud

Anyone can help fight Medicare fraud by staying alert and recognizing the signs. Here are some steps to take:

Review Your Medicare Summary Notice (MSN): Regularly check your MSN or Explanation of Benefits (EOB) for any services or charges that you do not recognize or did not receive.

Guard Your Medicare Number: Treat your Medicare number like a credit card number—keep it safe and never share it over the phone unless you initiated the contact.

Ask Questions: If you see anything suspicious, contact your healthcare provider’s office and ask for clarification. Mistakes happen, and it is important to determine if it was an error or something more serious.

Report Suspicious Activities: If you suspect fraud, you can report it to the Office of the Inspector General (OIG) or contact Medicare directly at 1-800-MEDICARE (1-800-633-4227). You can also reach out to the Senior Medicare Patrol (SMP), a group that helps educate Medicare beneficiaries on fraud and abuse.

What Happens After You Report?

Once a report is made, authorities will investigate the allegations. If fraud is confirmed, those responsible can face severe penalties, including fines, imprisonment, and exclusion from participating in federal healthcare programs. These actions serve as a deterrent and help recover lost funds to ensure that Medicare remains a sustainable program.

How You Can Participate in National Report Medicare Fraud Day

●      Educate Yourself and Others: Learn more about Medicare fraud and how to spot it. Share this knowledge with family, friends, and community members.

●      Stay Vigilant: Always monitor your Medicare statements and healthcare services closely.

●      Get Involved: Volunteer with local Senior Medicare Patrols or similar organizations to help educate others and assist with outreach efforts.

The Future of Fighting Medicare Fraud

As Medicare fraud continues to evolve, new tools and technologies are being developed to detect and prevent it. Artificial intelligence, data analytics, and increased collaboration between federal and state agencies all play a role in identifying and stopping fraudulent activities more quickly.

Bottom Line

National Report Medicare Fraud Day on September 12 reminds us all to help protect the Medicare system. By staying informed, vigilant, and proactive in reporting suspicious activity, we can help preserve this essential program for those who need it most. Protecting Medicare is a shared responsibility, and every report counts in the fight against fraud.

Sources:

https://nationaltoday.com/national-report-medicare-fraud-day/

Disclosures:

This information is an overview and should not be considered as specific guidance or recommendations for any individual or business.

This material is provided as a courtesy and for educational purposes only.

These are the views of the author, not the named Representative or Advisory Services Network, LLC, and should not be construed as investment advice. All information is believed to be from reliable sources; however, we make no representation as to its completeness or accuracy. Please consult your Financial Advisor for further information