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Social insurance programs such as Medicare is very helpful since it ensures that Americans ages 65 and over, younger individuals who are unable to make a living due to physical handicaps or end-stage renal disease are able to access healthcare services. Aside from paying for some of the costs incurred from hospital stays, and clinic visits, Medicare also gives its beneficiaries access to medicines that are sold at subsidized prices.

Unfortunately, the Medicare program has been a prime target for fraudsters. The program is said to be ripe for fraudulent activity because it uses an honor system of billing and has few safeguards to weed out false claims. Medicare fraud can take the form of phantom billing where the healthcare provider or supplier bills for services or supplies that were never rendered or delivered.

Unbundling is also another way of defrauding the Medicare program and it involves submitting several bills for tests or procedures that are usually less expensive when performed as a panel or at one time. Upcoding is also another tactic used by fraudulent providers and this involves submitting a bill for a higher CPT procedure codes than were actually performed, resulting in a higher payment by Medicare. Aside from medical professionals and suppliers, some patients can also defraud the Medicare program, like by giving their Medicare number in exchange for kickbacks.

Even though most of medical service providers are trustworthy, the small percentage of providers that milk Medicare through fraudulent means costs the country about 30 billion dollars per annum. Also, the sad thing is that recent cases show that fraudulent medical professionals are often willing to risk harming the patient just to carry out their schemes. Ultimately, Medicare fraud affects all of us since it drives up healthcare spending.

As a taxpayer or a recipient of such social program, you have to report Medicare fraud. However, before you make a complaint for billing errors, call your doctor or supplier first to have these rectified. More often than not, these mistakes are unintentional and can be quickly rectified. However, if they do not return your calls or do not cooperate, then call 1-800-MEDICARE or write the Medicare Company that paid the claim. If you prefer, you can also report Medicare fraud anonymously to the hotline maintained by the Office of the Inspector General.

Medicare fraud strains Federal and state budgets and contributes significantly to healthcare costs across the country. It also puts the welfare of the beneficiary at risk. Follow this link to learn where to medicare fraud.

Last year, there were talks about cutting the budget of Medicare further down as our political leaders weigh its impact in modern day society. Needless to say I am against that because Medicare is a basic social health service.

It is the federal government’s responsibility to provide the country with much needed social services. Social health services are there because they are basic services that we need like education, health and shelter.

Without any health care services, a lot of our fellow citizens will suffer because not everybody can afford to be in a nice hospital. This goes to show that health care services are very important and if Medicare continues to be abused by the millions or billions of dollars every year, there is a threat of this social service to be pulled out.

Medicare fraud occurs when the service is charged or billed for procedures that were even done in the first place. This means Medicare is being overbilled.

Among the most popular is phantom billing. This means billing for tests that weren’t really done and charging for supplies or equipment that were never even ordered.

Code jamming and unbundling are more of the common Medicare fraud types being committed. Code jamming means faking diagnosis codes are used to get coverage. Up coding on the other hand is faking codes and replacing them with higher costing codes to get extra coverage. Same thing with double billing, a service done is charged more than once.

Scammers are the only people who benefit from Medicare fraud while everybody else loses. We, the health care system and the government altogether lose whenever Medicare fraud is committed. These scammers are taking away and stealing money from the national fund which mostly comes from the taxpayers.

This is why we will all benefit from whistleblowers and honest practitioners. Most whistle blowers are concerned health care professionals who want to make sure everyone is just being fair. As whistleblowers, we should keep ourselves updated with current Medicare news and types of Medicare fraud being committed. Go to the official site of Medicare to report Medicare fraud that you have witnessed. There is also the Medicare fraud hotline to report any dubious activity going on.

We need to all be vigilant in fighting off Medicare fraud. Its time for everyone to be whistleblowers so click here to do a Report medicare fraud.

If you have information about a health care provider committing fraud on Medicare, you have a choice if you will just turn a blind eye or become a whistleblower. Whistleblowers have helped federal and state governments with the recovery of billions of dollars scammed out of Medicare.

Every year, billions of dollars are lost to scammers because people choose to simply shut up and take little care. What people should learn about is that the government rewards whistleblowers with around 15% to 30% of the total amount of dollars recovered.

There are several types of healthcare fraud or Medicare fraud being committed repeatedly by health care providers. One of them is charging for services that were never rendered and supplies that were never used. This is the most basic type of fraud being committed.

Medicare will only reimburse for services and supplies if they are proven to be medically necessary. Medicare verifies this by requiring documentation indicating doctor’s prescriptions and recommendations for the services rendered and supplies requested. Fraud is committed when health care providers falsify these documents just so they could charge Medicare.

Most of the procedures and supplies billed to Medicare are identified in codes. Each code corresponds to a procedure and a cost. Fraud happens when more expensive codes are submitted and charged to Medicare instead of the real ones. This type of fraud is called upcoding. Unbundling on the other hand is done when services are billed individually instead of in a bundle Some services are meant to be charged in a bundle and when services are unbundled, codes are much more expensive.

There are pharmaceuticals and medical devices that needs certification and approval by the FDA first before they can be sold off in the market. Medicare does not permit the reimbursement for these products. But there will always be non-approved off-label uses for this product and there will always be people who will tolerate them. Fraud happens when providers charge Medicare for non-approved or off-label usage. In order to be a whistleblower, there are pages online dedicated to Medicare fraud reporting. There is also the Medicare fraud hotline ready to accept calls for fraudulent activities being reported.

The country loses billions of dollars every year because of Medicare fraud. Click here to learn how to get to a page for medicare fraud reporting