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June 2022 marked the 25th anniversary of the Senior Medicare Patrol (SMP) Program. To commemorate this event, the first week in June was recognized as Medicare Fraud Prevention Week.

Why is Medicare Fraud Prevention so Important?

Medicare loses an estimated $60 billion each year to fraud, errors, and abuse. Every day, issues related to these matters affect people across the country, often costing them money, time, and a sense of well-being. Medicare-related errors contribute to this annual loss even though errors can be honest health care billing mistakes. However, a pattern of errors committed by a physician or provider could be considered a red flag of potential fraud or abuse if not corrected. When people steal from Medicare, it hurts us all and is big business for criminals. Some common examples of fraud or abuse:

–Charging for services or supplies that were not provided

–Misrepresenting a diagnosis, a person’s identity or services provided to justify payment

–Prescribing or providing excessive or unnecessary tests and services

Falling prey to scams or health care fraud may mean that your Medicare number has been “compromised” as a result of medical identity theft. Theft from Medicare fraud threatens the integrity of the Medicare program and potentially affects available funds for those needing future Medicare services. The most effective way to stop fraud from occurring is to prevent it in the first place. Educating ourselves on how to prevent Medicare fraud, errors, and abuse is the best place to start.

If you are a Medicare beneficiary, learn how to read your Medicare statements, the MSNs or EOBs, either in paper format that comes in the mail or go online to Medicare.gov and review claims digitally.

Remember the three steps: Prevent, Detect, Report!

Prevent: Learn how to read your MSN. You can also call or email your SMP to learn how to best protect yourself and your loved ones from health care fraud, errors, or abuse.

Detect: When reviewing your MSN or EOB, look for services, products, or equipment you didn’t receive, double charges, or items your doctor didn’t order.

If you find items of concern, call the doctor or company in question and ask them about potential mistakes. Call SMP if you still have questions.

Report: Call or email your local SMP if you believe that you have experienced health care fraud, errors, or abuse.

Learn more: Visit smpresource.org to find out how to protect yourself and loved ones from Medicare fraud.

Reporting Medicare fraud: If you think you have spotted fraud, report it. ND SMP will help seniors prevent, detect and report Medicare fraud. If you see anything suspicious, contact the ND SMP at ndsmp@minotstateu.edu or call 1-800-233-1737 or 701-858-3580.  For non-Medicare fraud issues, contact the ND Attorney General’s Office at 1-800-472-2600.

The information provided is intended to be a general summary only. Source of information: SMP Resource Center (25 April 2022).

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