Protect Your Medicare by Reviewing Your Medicare Summary Notice

Firstly, let’s define what we mean by fraud, waste, and abuse in the context of Medicare.

• Fraud: Intentional deception or misrepresentation that results in an unauthorized benefit.
• Waste: Overutilization of services or other practices that result in unnecessary costs.
• Abuse: Practices that are inconsistent with acceptable business or medical standards and result in unnecessary costs.

It’s important to recognize that Medicare fraud, waste, and abuse affect us all. Whether you’re a current Medicare beneficiary, a taxpayer, or a future beneficiary, the repercussions can be far-reaching. With each instance of fraud, the Medicare system loses resources that could otherwise be used to provide better care, lower costs, or expand coverage. This directly impacts everyone who contributes through Medicare taxes.

The 4R’s of Medicare Fraud

If you have ever received a bill in the mail from your doctor? It’s important to check the accuracy of what your billed for during visits with providers by reviewing the Medicare Summary Notices (MSN). Medicare Summary Notices are not bills, they are notices that people with Original Medicare get regarding Medicare Part A and Part B covered services. Fraud and abuse are real so if your on Medicare get a journal and commit these 4 things to memory:

Record

Use a calendar and a journal. Take notes of the tests and services you received and save receipts for reference later. Use the help of friends and trusted family members with help in taking notes. If you need a journal and live in Florida you may contact your local Senior Medicare Patrol (SMP) program at 800-963-5337 or 877-808-2468.

Review

Always be on the lookout for signs of fraud including claims you might not recognize on your Medicare Summary Notices. Be weary of any phone calls from companies offering free items like Durable Medical Equipment (DME). Compare dates and services in your journals with those listed on your Medicare Summary Notice and make sure that you received each service or item. Any discrepancies may indicate the possibility that you might have been billed for something you did not get. One of the simplest yet most effective ways to combat Medicare fraud is by carefully reviewing your Medicare Summary Notice (MSN). Your MSN provides a summary of services or supplies billed to Medicare under your name. By reviewing this document regularly, you can spot any discrepancies, such as charges for services you didn’t receive or billing errors.

Report

If you suspect any fraudulent activity or discrepancies in your MSN, it’s crucial to report it promptly. If you find fraud you may call the SMP to get assistance with making a report to Medicare. Here are some avenues through which you can report Medicare fraud:

1. Medicare: You can report suspected fraud directly to Medicare by calling the Medicare hotline at 1-800-MEDICARE (1-800-633-4227).
2. Office of the Inspector General (OIG): The OIG investigates allegations of fraud, waste, and abuse in Medicare. You can report suspicions to the OIG’s hotline at 1-800-HHS-TIPS (1-800-447-8477) or online at oig.hhs.gov.
3. State Health Insurance Assistance Program (SHIP): SHIP provides free counseling and assistance to Medicare beneficiaries. They can help you understand your MSN and assist in reporting suspected fraud. Find your local SHIP office at shiptacenter.org.
4. Local Law Enforcement: In cases of suspected fraud or abuse, you can also contact your local law enforcement authorities or state Medicaid Fraud Control Unit (MFCU).

Remember

Never hand out your Medicare Beneficiary Identification Number unless your doctor or provider requests it. Never give out your Medicare number in exchange for any special offers. Medicare does not call or contact you to ask for personal information like bank account or social security numbers. Never let anyone use your card and never use anyone else’s. reviewing your Medicare Summary Notice and reporting any discrepancies or suspected fraud is not just about protecting your own interests; it’s about safeguarding the integrity of the Medicare system for everyone. By being vigilant and proactive, we can all play a part in combatting fraud, waste, and abuse, ultimately ensuring that Medicare remains a reliable and sustainable healthcare resource for generations to come.