Medicare and Medicaid Fraud: How to Protect Yourself

Medicare and Medicaid fraud is when healthcare providers or suppliers knowingly submit false or misleading information to Medicare or Medicaid for reimbursement. This can include billing for services not rendered, providing unnecessary medical equipment, or receiving kickbacks for referrals.

Medicare and Medicaid fraud can lead to higher healthcare costs for taxpayers and beneficiaries, reduced access to healthcare services, and compromised quality of care.

You can protect yourself from Medicare and Medicaid fraud by reviewing your healthcare bills and statements for accuracy, not sharing your Medicare or Medicaid number with anyone except trusted healthcare providers, and reporting suspicious activity to the Medicare Fraud Hotline at 1-800-HHS-TIPS (1-800-447-8477).

Examples of Medicare and Medicaid fraud include billing for services not rendered, upcoding (billing for a more expensive service than was actually provided), providing unnecessary medical equipment, and receiving kickbacks for referrals. Fraud can also occur when healthcare providers waive Medicare or Medicaid co-payments or deductibles.

If you suspect Medicare or Medicaid fraud, you should report it to the Medicare Fraud Hotline at 1-800-HHS-TIPS (1-800-447-8477). You can also contact your state’s Medicaid Fraud Control Unit.

The consequences of committing Medicare or Medicaid fraud can include fines, imprisonment, exclusion from Medicare and Medicaid programs, and loss of professional licensure.