Medicare is one of the biggest government programs in the US and as such it is subject to a lot of issues, but one of the issues that not many beneficiaries take seriously is fraud within the program. Most Medicare fraud is not perpetrated by beneficiaries of the program, and it sill amounts to billions of dollars lost every year, which puts in peril the entire healthcare system and puts real people at risk.
Even if you do not personally feel affected by Medicare fraud, it is a systemic issue that can affect all healthcare needs, as when the program needs money and does not have it, it compromises the care of all beneficiaries, which means that you cold end up getting poor-quality treatment or even none at all.
Why Medicare fraud is an issue we should all care about
As more Americans hit retirement age and become eligible for Medicare, the importance of protecting the program keeps growing, especially since there are not enough people joining the workforce to cover those who leave. The good news is that most doctors and healthcare workers are honest and provide excellent care and do not overcharge the system, but verification is lax as it would take up valuable resources, and so the system relies on trust a lot and it is easy to take advantage for a skilled bureaucrat.
Since it is taxpayer money that funds this program, the one suffering because of the instances of fraud are the taxpayers. But it can be hard for patients to know what counts as Medicare fraud as there are many things that qualify. The most common and obvious ways professionals take advantage of the system is by making fake claims, billing for treatments or tests that never happened, or pushing procedures that are not actually necessary (as we all know doctors bill insurance companies and Medicare at a much higher cost than what procedures and materials cost for tests, which allows them to turn massive profits on routine tests and procedures).
There is also another type of fraud that is not as obvious, especially for patients, which is charging too much for a service or using the wrong billing codes to get more money from the program. This can be a simple mistake, but oftentimes it is not, and reporting both instances is important to ensure that there is no abuse that can cost the program unnecessary money and compromise patient care.
Most patients think that there is nothing they can do about this, which is not true at all, as the main thing that you can do is be aware of what treatments you are receiving and what they are for. This not only allows you have a better handle on your own needs as a patient but it can also help you with disputing bills and getting treatments that you did not receive taken off your bill or ensuring that the correct codes are input for billing.
Since Medicare sends out statements regarding appointments and procedures received, look over everything and check that the dates and services actually match up with your calendar and treatment plan so that you can spot any inconsistencies.
Something else you can and should do is to protect your Medicare information like you would your financial data. Keep your Medicare card safe and do not hand out your Medicare or Social Security number unless you are dealing with a provider you trust and then check the statement to ensure that it has not been used in an untoward fashion.
And last, but by no means least, if something feels off, like a charge for a service you did not receive or a suspicious phone call, it is important to act and talk to your provider and try to get things cleared up. If you still are not satisfied, you should report it to the program so they can investigate.