Medicare fraud costs roughly $60 billion a year, raising the cost of healthcare for everyone and making it harder to access the care you need. Our Statewide Health Insurance Benefits Advisor (SHIBA) volunteers and the Senior Medicare Patrol (SMP) help Medicare beneficiaries, their families and caregivers to prevent, detect and report Medicare fraud.
Prevent, detect and report Medicare fraud
Check out these quick tips and be on alert for Medicare fraud, errors and abuse.
How SHIBA can help you
Fraud can happen at any time. It can look like criminals stealing directly from Medicare or doctors, pharmacies or medical suppliers providing care or equipment you don’t actually need.
The volunteers with SHIBA and the Washington SMP project can provide everyone involved in your care with the information and tools needed to look out for and prevent fraud before it happens. If you suspect fraud has already happened, our volunteers will help answer any questions you have and report your concerns so they can be investigated.
You can call SHIBA at 800-562-6900 or submit a suspected fraud report online.
How to identify Medicare fraud
There are several steps you can take to help prevent and identify fraud:
- Keep a file of all your receipts and bills and regularly review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) to be sure you received all the care that is listed.
- Treat your Medicare card like a credit card.
- Don’t let anyone borrow or pay to use your Medicare number.
- Don’t give out your personal information such as your Medicare number, Social Security number, bank account or credit card numbers to anyone unless you initiated the contact.
Medicare will never contact you to ask for personal information.
Scams and fraud are always evolving. Learn about the latest fraud trends and most common areas of fraud by visiting the national Senior Medicare Patrol Resource Center.
Scam calls
If you experience frequent scam calls, even after you sign up for the “do not call list,” visit the Federal Trade Commission page regarding phone, email or text scams. The FTC also provides information on how to protect yourself from financial exploitation and consumer fraud.
Social Security fraud
If you have had your Social Security number stolen or used without your permission, visit the Social Security Administration to report fraud. Social Security provides information about Social Security benefits and how to keep your Social Security number safe from identity theft.
Washington State Medicaid/Apple Health fraud
Washington Health Care Authority is the State’s Medicaid, behavioral health, and public employee benefit authority. Medicaid beneficiaries who suspect services, supplies, or access to services have been claimed fraudulently or misrepresented, report suspected Medicaid fraud at 1-833-794-2345 or email hottips@hca.wa.gov.
To learn more about their programs and how to prevent fraud visit the Health Care Authority.
Billing errors or complaints?
First, contact your plan or provider to resolve the issue. If this is not satisfactory, submit your complaint online.