Medicare Fraud

There are individuals who are intent on abusing or defrauding Medicare, cheating the program (and in some cases the people with Medicare who are liable for co-payments) out of millions of dollars annually. Medicare fraud takes a lot of money every year from the Medicare program that is paid for by people with Medicare through higher premiums.

The federal False Claims Act can be an effective tool for patients, employees and others to combat Medicare Fraud. Medicare fraud is purposely billing Medicare for services that were never provided or received.

Some examples of Medicare fraud include:

• Billing Medicare or another insurer for services or items a patient never received.
• Billing Medicare for services or equipment which is different from the services or equipment actually provided to the patient. This practice is commonly referred to as “upcoding.”
• Use of another person’s Medicare card to get medical care, supplies, or equipment.
• Billing Medicare for home medical equipment after it has been returned.