As of June 30, 2016, there have been 1,522 criminal actions totaling $1.98 billion in Medicare Fraud according to the Office of Inspector General, U.S. Department of Health and Human Services.
Here is how health care fraud works: Medicare and Medicaid identification numbers are the same as your Social Security number and one of the quickest ways to commit health care fraud. Experienced Medicare or Medicaid scammers know the right questions to ask.
A north Idaho woman received a call from “Mark” who described himself as being affiliated with a national pharmacy chain. He left a recorded message to call back and included a reference number as an additional sign of legitimacy.
When she called back it was a recording that asked her to validate her phone number and then asked for her date of birth and zip code. Next the recording indicated eligibility for a 90-day prescription rather than monthly. When she tried to confirm the website and 1-800 phone number, the email did not go through, and the message was a recording offering a $25 gift card if the caller answers questions, one asking if the caller is over 50 years old.
When she followed up with the pharmacy directly they indicated it was not them who made the inquiry and that they were not affiliated with the caller.
As enrollment opens for Medicare on October 15, here are some things to keep in mind:
Protect your Medicare/Medicaid number. Your Medicare number is the same as your Social Security number, which is one of the quickest ways to steal your identity and commit health benefits fraud. Do not carry your Medicare/Medicaid card with you unless absolutely necessary. Your health care provider should have it on file if you have provided it in the past.
Track your medical appointments and supplies. A great way for people to use your benefits is to use your number for health care appointments or medical supplies. Be sure to keep track of your appointments and medical supply benefits. Contact your medical provider if you receive an Explanation of Benefits notice for an appointment or equipment you did not schedule or order.
Double-check your prescriptions. Confirm that your pills or medications are for the prescribed amount and are generic or brand name. Scammers can alter your prescriptions to pocket the difference in costs.
For more consumer protection tips and information on BBB investigations, visit bbb.org/northwest. To report an incident to Scam Tracker, visit www.bbb.org/scamtracker.
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