Health care fraud cases on the rise

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Sunday, May 17, 2015
Healthcare fraud cases on the rise
Health care fraud is becoming a national epidemic. As health care expenditures continue to outpace inflation, the problem is getting more serious by the day.

Health care fraud is becoming a national epidemic. As health care expenditures continue to outpace inflation, the problem is getting more serious by the day.

But there are ways to figure out if you have been caught in a scheme to rip-off our health care system.

Health care fraud costs American taxpayers more than $80 billion a year, according to federal officials.

"Health care fraud is not a victimless crime. It's costing taxpayers billions of dollars but it's also putting people at risk because people are getting unnecessary or possibly unsafe medical procedures that they don't really need in the first place," said Julie Kenney, U.S. Postal Inspection Service.

So how can you tell if you're a pawn in a health care fraud scheme?

"Somebody is billing Medicare for services you did not receive, services different than what you've received, or services that you weren't that aren't medically necessary for you or you're not entitled to," said Jason Echols, health care consumer coordinator.

The easiest way to know if your coverage has been compromised is to read your Medicare summary notice carefully. Patients usually receive one every three months.

"On that statement you can see what's being billed to Medicare and how much Medicare paid, how much you would be responsible for the co-insurance and co-payment," Echols said.

Same for an insurance company's explanation of benefits form. Read each charge thoroughly to make sure it's legitimate.

Another problem area is home health care. Scam artists often call elderly patients and offer them services.

"Do you want somebody to come check your blood pressure or would you like somebody to come clean your house, or buy you groceries?" Echols said.

While they sound helpful, they are not home health care services approved by a doctor.

"Once they have your Medicare number, they can bill Medicare, they can falsify documents to bill Medicare maybe they come to your house and maybe they do clean your house one or two times - that's it - they are not providing skilled nursing," Echols said.

If you have reason to believe you've been a victim of health care fraud, call 1-800-MEDICARE. The line will get you to your state advocate, who can then provide you with assistance.