Medicare Fraud Schemes from the Office of Inspector General

The Department of Health & Human Services (HHS) established and oversees multiple health care programs, including Medicare and Medicaid. Within HHS is the Office of Inspector General (OIG), whose task is to make sure criminals and fraudsters do not steal your Medicare funds. The OIG considers the Senior Medicare Patrol (and you) as an integral partner in the fight against fraudulent activity in our health care system.

Medicare fraud is a growing problem that costs American taxpayers billions of dollars a year. While law enforcement efforts to combat fraud, waste and abuse within the Medicare program have come a long way, criminals are still hard at work trying to find a variety of ways to defraud the government and its U.S. taxpayers. As the first line of defense against Medicare fraud, you should protect your personal information and become more aware of the dangers. Also, recognize the diverse range of schemes that criminals use. Report any suspicious activity. This will help law enforcement efforts by showing criminals that Medicare fraud will not be tolerated. When Senior Medicare Patrol projects learn of possible Medicare fraud, they report it directly to the OIG.

Medicare Part A Schemes

• Skilled Nursing Facility Fraud
• Home Health Care Fraud

Medicare Part B Schemes

• Durable Medical Equipment Fraud
• Wheelchair Scams
• Pain Management Clinics
• Behavioral Health (Community Mental Health Centers)

Medicare Part C Schemes

• Medicare Advantage/Managed Care Fraud 

Medicare Part D Schemes

• Prescription Drug Fraud

General Schemes

• Telemarketing Fraud
• Medical Identity Theft
• Beneficiary Fraud

Report Suspected Fraud

To report suspected fraud, click here.