Words from the Sheriff: Protecting residents from healthcare fraud

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Erath County Sheriff Tommy Bryant

The following information and fraud prevention tips are from the HealthCare Financing Administration (HCFA).

Medicare fraud includes, but is not limited to: 

  • Billing for more expensive services at a high service fee than was provided.
  • Falsifying certificates of medical necessity, plans of treatment, and medical records to justify payment.
  • Billing for services not furnished.
  • Soliciting, offering, or receiving a kickback.
  • Misrepresenting the diagnosis to justify payment.

Protect yourself against healthcare fraud:

  • Never give your Medicare or Medicaid numbers over the telephone or to people you do not know.
  • Beware of health care providers and suppliers who use telephone calls and door-to-door selling as a way to sell you goods or services.
  • Be suspicious of companies that offer free medical equipment or offer to waive your co-payment without first asking about your ability to pay.
  • Beware of health care providers who say they represent Medicare or a branch of the Federal government, or providers who use pressure tactics to get you to accept a service/product.

You should be suspicious if the provider tells you that:

  • The test is free-they only need your Medicare number for their records.
  • Medicare wants you to have the item or service.
  • They know how to get Medicare to pay for it.
  • The more tests provided, the cheaper they are.
  • The equipment or service is free; it won’t cost you anything.

Be suspicious of…

  • Home health providers who offer non-medical transportation services or housekeeping as Medicare approved services.
  • Ambulance companies that bill Medicare for non-emergency trips.
  • Suppliers who bill Medicare for medical equipment for beneficiaries in nursing homes.
  • Physicians who give the wrong diagnosis on the claim form so Medicare will pay.

Reporting Medicare fraud and abuse:

If you have a questionable charge on your bill, call the provider, your Fiscal Intermediary (for Part A bills) or your Medicare carrier (for Part B bills). If you believe that a health care provider may be cheating or abusing the Medicare program, call the Medicare carrier or intermediary that sent you the payment notice. Their name, address, and telephone number appear on the payment notice. After you call the Medicare carrier or fiscal Intermediary. You may also call the Inspector General’s hotline at 1-800-HHS-TIPS (1-800-447-8477), or TTY for the hearing and speech impaired: 1-800-377-4950.

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