What is Medicare Fraud?

Medicare is a health insurance program administered by the Social Security Administration for individuals in the United States aged sixty-five and over or disabled. Medicare is financially supported by the United States federal government. Medicare was originally established with two costs which included both hospital costs and non hospital costs, like the costs associated with doctor visits.

Medicare has evolved from its originally established position of only covering hospital and doctor expenses to now include additional coverage options like its prescription drug programs. Individuals who are covered under Medicare hospital insurance also have the ability to pay small monthly premiums in order to obtain additional federal medical insurance.

Both employees and employers alike contribute to Medicare through taxes. There is no limit on the amount of personal income that is subject to Medicare related taxes. Social security nearly covers all jobs located in the United States—around nine out of ten of them. There has been a growing concern as the state of the economy continues to deteriorate over more and more people around the country committing Medicare fraud.

Medicare fraud can be defined as a phrase that describes an individual, company or corporation that acts to intentionally try to steal money from the federal government. This is done by submitting Medicare health care reimbursement claims, without having performed any duties.

Fighting Medicare fraud can be a very tough task for the government, because it is difficult for them to initially detect the fraud and many of the cases they do investigate on suspicion of fraud turn out not to be fraudulent in nature. Knowing the exact number of dollars improperly dished out by the government is unknown. However, the Office of Management and Budget releases an estimation of the damages totaled about $48 billion dollars in 2010 alone.

The most common type of Medicare fraud committed is referred to as “Phantom Billing,” which describes a medical provider billing Medicare for completely unnecessary medical procedures and even procedures the never performed. Basically providers over state expenses on their Medicare claims about the extent of the services and equipment they provide their patients with.

Medicare fraud ends up hurting taxpayers the most and will only result in higher costs, which in turn will lead to higher taxes. Medicare fraud leads to the loss of millions of dollars each and every day, and the individuals in need of medical care are hurt the most by this crime.

Individuals covered under the Medicare health insurance program can help prevent Medicare fraud by attentively going over their Medicare Summary Notice. They can go through their MSN to make sure every good or service listed on the statement was actually given to them or performed on them.

Abnormalities on these notices are one of the warning signs that Medicare fraud could be going on. If you are a Medicare patient, or a concerned loved one of a Medicare patient, then you can call a hotline at 1-800-447-8477 to report suspicious activity that could add up to Medicare fraud.