What is Healthcare Fraud?

 

Healthcare Fraud, waste, and abuse occur in all parts of the healthcare industry. Here are some examples:

• A home health agency bills Medicare for services that you never received.

• A medical equipment company bills Medicaid for a wheelchair that you didn’t need.

• A hospital purposely uses the wrong code for a lab test so they can get paid more.

• A podiatrist visits a senior apartment building. He offers to trim everyone’s toenails, as long as they give him their Medicare numbers. He uses the residents’ Medicare numbers to bill Medicare for foot surgery.

• A doctor offers his patients money or gifts if they come to him for services.

• An insurance agent signs someone up for an insurance plan without her permission.

• An insurance agent lies to people about an insurance plan’s coverage to get them to join.

How Does the SMP Program Help Stop Healthcare Fraud?

 

To help consumers stop fraud, SMP staff and volunteers:

• Give presentations on healthcare fraud to groups

• Provide information on healthcare fraud at community events

• Help people report fraud when it occurs

 

Request a Presentation on Health Care Fraud

 

If you would like to request a presentation on healthcare fraud, contact AgeOptions at (800)699-9043 or call your nearest SMP partner agency:

SMP Partner Agencies and their Contact Information

 

This project was supported in part by grant numbers 90MP0026 and 90MP0127 from the U.S. Administration on Aging, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration on Aging policy.