Medicare Fraud Medicare fraud occurs when someone knowingly deceives Medicare to receive payment when they should not, or to receive higher payment than they should. See also: Marketing Violations.  occurs when someone knowingly deceives Medicare Medicare is the federal government health insurance program that provides health care coverage if you are 65 or older, are under 65 and receive Social Security Disability Insurance (SSDI) for 24 months, begin receiving SSDI due to ALS/Lou Gehrig’s Disease, or have End-Stage Renal Disease (ESRD) no matter your age. You can receive health coverage directly through the federal government (see Original Medicare) or through a private company (see Medicare Advantage). to receive payment when they should not, or to receive higher payment than they should. Committing fraud is illegal and should be reported. Anyone can commit or be involved in fraud, including doctors, other providers, and Medicare beneficiaries.
AÂ Provider See Health Care Provider. is committing fraud if they:
- Bill Medicare for services you never received
- Bill Medicare for services that are different from the ones you received (usually more expensive)
- Continue to bill Medicare for rented medical equipment after you have returned it
- Offer or perform services that you do not need in order to charge Medicare for more services
- Tell you that Medicare will pay for something when it will not
- Use another person’s Medicare number or card
To report fraud, contact 1-800-MEDICARE (633-4227), the Senior Medicare Patrol (SMP) Resource Center (877-808-2468), or the Inspector General’s fraud hotline at 1-800-HHS-TIPS (447-8477). Medicare will not use your name while investigating if you do not want it to.