Fraud Schemes - Senior Medicare Patrol

Below is a list of common areas Medicare fraud occurs.

If you or a loved one may have been a victim of any of these schemes, contact your SMP, the OIG Hotline, and/or local law enforcement.

Ambulance Fraud

Medicare covers ambulance services when they are medically necessary. To qualify for coverage, the ambulance and its crew must meet certain standards...

COVID-19 Fraud

As the COVID-19 Public Health Emergency comes to an end, fraudsters are still attempting to bill Medicare for sham tests or treatments and are...

Durable Medical Equipment Fraud

Durable medical equipment (DME) and orthotics companies offer a valuable service by providing wheelchairs, surgical supplies, catheters, and...

Genetic Testing Fraud

Scammers are offering Medicare beneficiaries cheek swabs for genetic testing to obtain their Medicare information for fraudulent billing purposes or...

Home Health Care Fraud

Medicare Parts A and B cover intermittent or short-term home health services. These services must be provided by a Medicare-approved home health...

Hospice Fraud

Hospice is an important benefit for the Medicare population. Hospice fraud threatens this benefit for all beneficiaries. Scammers are getting...

Medical Identity Theft

Medical identity (ID) theft occurs when someone steals personal information – such as a beneficiary’s name and Medicare number – and uses...

Medicare Card Scams

In 2018, Medicare updated the Medicare card from containing a person’s Social Security number to a random identifier that includes numbers and...

Medicare Marketing Violations and Misleading Marketing

Unlike Original Medicare, Medicare Part C and Part D are administered, marketed, and sold by private insurance companies. The Centers for Medicare...

Nursing Home Care Fraud

Medicare doesn’t generally pay for long-term nursing home care. However, Medicare Part A covers medically necessary, short-term care in a skilled...

Outpatient Mental Health Care Fraud

Outpatient mental health care can be an important benefit to a beneficiary. Medicare covers outpatient mental health services in settings such as a...

Pharmacy and Prescription Drug Fraud

Pharmacy and prescription drug fraud is a consistent trendin Medicare. Due to the lucrative nature of prescription drug diversion andpharmacy scams,...

Remote Patient Monitoring (RPM) Fraud

Remote patient monitoring (RPM) is the ability for health care providers to monitor certain parts of a person’s health from their home. Providers...

Telehealth Fraud

Due to the recent expansion of telehealth services and the ease in which this fraud can be committed, criminals are exploiting this new technology...

Tip Sheets for Printing

This handout includes common Medicare fraud schemes in one document for ease of printing. The schemes included are: Ambulance Cardiac Genetic...

More Information

Federal Trade Commission Consumer Information page
Office of Inspector General Consumer Alerts page