Why You Need To Inform Authorities About Suspected Medicare Abuse
Posted by Theodore Keowaller in Uncategorized, tags: general, health, insurance, law, legal, misc, Miscellaneous, news, UncategorizedThe Medicare program is ripe for fraudulent activities because it is based on the “honor system” of billing. Most doctors, healthcare providers, suppliers, and private companies are trustworthy. However, there are those who are not. Adding to this vulnerability is the lack of safeguards that can root out fake claims, since the federally-funded health insurance program puts more emphasis on expediting and streamlining reimbursement, than validating the veracity of claims.
The government loses roughly around sixty billion dollars per annum from these fraudulent activities targeted at the Medicare program, which makes it one of, or the most profitable illegal venture in the US today. Medicare fraud is a quiet crime, and the ones receiving the brunt of these activities are the beneficiaries and the citizens who pay their taxes dutifully, and most of the time, they aren’t even aware that they are being scammed. It’s a domino effect really, the more money the Medicare program loses, the higher the healthcare costs will be eventually. This underscores the importance of prompt and proper Medicare fraud reporting.
Medicare fraud reporting
If you find procedures that were not rendered or supplies that were not given to you on your Medicare summary notice, you should first call your physician or supplier to correct those. If you cannot contact them, or your queries are being ignored, or they refuse to assist you, consider calling the Medicare fraud hotline at 1-800-MEDICARE or 1-800-633-4227. Those who are using TTY devices may contact 1-877-486-2048. To further assist you, the Office of the Inspector General also maintains a Medicare fraud hotline, which offers a confidential means of reporting vital information. The hotline can be reached via phone, fax, snail mail, or e-mail. There is also a dedicated Medicare fraud hotline for those living in Florida.
A little-known statute actually exists which “deputizes” citizens to file a complaint against individuals or providers who deliberately submit fraudulent claims to federal agencies such as Medicare. This “qui tam” provisions can be found under the US Civil False Claims Act. The said legislation also provides protection to qui tam plaintiffs against demotion, suspension, discrimination or any form of harassment in terms of employment.
Whistleblowers are entitled to 15-30% of the government’s total recovery. To recover this bounty, the complainant should comply with complex statutory requirements. Merely giving info over the Medicare fraud hotline will not make them eligible to receive such bounty.
Fraudsters milk billions of dollars from our healthcare system yearly, making prompt Medicare fraud hotline necessary. You can find the Medicare fraud hotline and overview of the reporting procedure here.
Entries (RSS)