Medicare Fraud Schemes

Fraud Schemes

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

 

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

 

COVID-19 Fraud

Scams related to the coronavirus, also known as COVID-19, are rapidly increasing as the public health emergency develops. Scammers are targeting older adults...


Durable Medical Equipment (DME)/Orthotics Fraud

 

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

 

Genetic Testing Fraud

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


Home Health & Custodial/Personal Care Fraud

 

Home Health Care Fraud

For Medicare beneficiaries to be eligible for home health care services, they must be under the care of a physician. The physician must certify that the beneficiary...


Hospice Fraud

 

Hospice Fraud

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


Medical Identity Theft

 

Medical Identity Theft

Medical identity theft occurs when a beneficiary’s Medicare number is misused, either by a provider, a supplier, or by someone posing as the real beneficiary...


Medicare Enrollment Fraud & Marketing Violations

 

Medicare Marketing Violations and Enrollment Fraud

Medicare plans cannot conduct unsolicited phone calls to beneficiaries with whom they have no prior relationship...


 

Nursing Home Fraud

Skilled nursing facilities play a crucial role in providing therapy and rehabilitation after you or a loved one have suffered a debilitating illness or stroke. After a qualifying stay in the hospital, Medicare beneficiaries...


Outpatient Mental Health Care Fraud

 

Outpatient Mental Health Care Fraud

Providing mental health services in outpatient clinics saves the government and taxpayers a tremendous amount of money. It also allows the patient to...


Pharmacy and Prescription Drug Fraud

 

Pharmacy and Prescription Drug Fraud 

Pharmacy and prescription drug fraud is a consistent trend in Medicare. Due to the lucrative nature of prescription drug diversion and pharmacy scams...


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...


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