Medicare fraud is suspected when Medicare is billed for services or supplies not received.
Medicare abuse is considered when doctors or suppliers do not follow accepted medical practices leading to unnecessary costs to Medicare, improper payment or services provided that are/were not medically necessary.
Examples of possible Medicare fraud include:
- A healthcare provider charging Medicare for services never received
- A supplier billing Medicare for equipment never delivered
- A company using false information to mislead someone into joining a Medicare plan
Examples of possible Medicare abuse include:
- Using incorrect codes on a claim
- Charging excessively for services or supplies
- Billing for services that were not medically necessary
For information about how to spot and report Medicare fraud and abuse, please refer to the following website:
To report suspected errors, fraud or abuse, contact:
Centers for Medicare & Medicaid Services(CMS) Medicare Fraud Hotline
Mail: Medicare Beneficiary Contact Center
P.O. Box 39
Lawrence, KS 66044