Protect Yourself from Medicare Fraud – Riverside County

The Health Insurance Counseling & Advocacy Program (HICAP) and Senior Medicare Patrol (SMP) educate beneficiaries about Medicare and help prevent healthcare fraud.

Protecting your personal information is the best line of defense in the fight against Medicare fraud and abuse.

Medicare and Medicaid fraud can be committed by medical professionals, healthcare facilities, patients, and others who pretend to be one of these parties.
Common examples of fraud include billing for services that weren’t provided, performing unnecessary tests, and receiving benefits when you’re not eligible.

Prevent, Detect, Report!

Prevent health care fraud by protecting your medical identification cards and numbers.

Even when you do everything right, there is a chance that you could be a target of fraud. Detect fraud by examining both the Medicare Summary Notice (MSN) you receive from Medicare after your claims are paid, and/or the Explanation of Benefits (EOB) you receive from your Part C and/or Part D plan.

If you suspect fraud in your healthcare, report it!

Common Health Care Scams

Services Not Provided – beneficiaries are billed for services never received or health care providers change billing codes or submit fake claims.
Medical Equipment Fraud – equipment manufacturers may offer “free” products or waive required copayments or deductibles in exchange for a Medicare number.
Free Health Screenings – a vendor offers to provide “free” health care screenings, lab tests or other services but asks for a person’s Medicare number.
Insurance Bait & Switch or Cross-selling – licensed agents present information about a Medicare Advantage plan, describing benefits and services that the plan doesn’t offer, and then sign people up for a plan that isn’t right for them.
Counterfeit Prescription Drugs – beneficiaries purchase medication over the Internet to save money, but the drugs they receive are not the right medication or the right dosage.
Medical Identity Theft – this can happen when someone uses a person’s Social Security number or Medicare number, date of birth, credit card number or other personal information. This information can be obtained by asking for it at an event or over the phone or stealing information from a wallet or the trash.

Take your time!

Complete the 4 steps BEFORE you make changes to your Medicare.

1 – Ask Questions. 2 – Take your Time. 3 – Understand. 4 – Call HICAP.

Report suspected health care fraud and abuse to your local SMP Program at 1-855-613-7080

Free, unbiased Medicare counseling and assistance Health Insurance Counseling and Advocacy Program (HICAP)

1-800-434-0222

Report suspected Medicare fraud, waste and abuse California Senior Medicare Patrol (SMP)

1-855-613-7080

This project was supported, in part by grant number 90MPPG0019-04-00 from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. This project is funded by the California Department of Aging, as allocated by the Riverside County Board of Supervisors, and administered by the Riverside County Office on Aging.