Ohio Protecting Yourself from Medicare Fraud & Identity Theft
Medicare/Medicaid Fraud • The General Accounting Office estimates that $1 out of every $7 spent on Medicare & Medicaid is lost to fraud, waste & abuse. • Medicare fraud, waste & abuse cost you and me $60 billion a year.
Medicare Fraud Is Not… Honest mistakes bythe provider Bills from providers whose names you may not recognize such as anesthesiologists and radiologists Hospital bills that are just “too high”!!
What is Fraud? • Fraud is an intentional deception or misrepresentation that the individual makes, knowing it to be false and that could result in some unauthorized benefit.
Medicare Fraud & Abuse • Offering free medical tests in exchange for a Medicare number. • Recreational activity billed as therapy sessions.
Home Health Care Fraud & Abuse Things to look for: • Beneficiaries who are not homebound. • Medicare Summary Notices (MSN) showing more services than those actually provided. • Unnecessary home visits.
Nursing Facility Fraud & Abuse Things to look for: • Therapies given to groups of patients but billed as if provided individually. • Every patient has the same medical equipment.
Durable Medical EquipmentFraud & Abuse Things to look for: • Doctors who order unnecessary equipment or supplies. • Recruiters who solicit benies for Medicare numbers and bill for power scooters.
Medicare/Medicaid Fraud, Waste and Abuse • Most providers are honest • Only 2-3% bill fraudulently
Help Fight Medicare Fraud • Always Review Your Medicare Summary Notice (MSN). www.mymedicare.gov • Always Keep a Record of Your Services and Appointments • Never accept Medical Supplies or Equipment Door-to-Door.
What if I find an error? Follow these steps in this order ! • Call the provider to determine if it is a mistake. • If you are dissatisfied with the response, gather all the facts that you know about your situation. • Call Ohio SMP 1-800-488-6070 and ask for Dave.
Current Fraud • Identity theft • Companies are sending emails, mailers and setting up websites to get your contact information.
How Can Someone Steal My Identity? • Take mail from your mailbox. • Take bills, credit card information or statements from your trash.
How Can Someone Steal My Identity? • Eavesdrop on your public • telephone calls when you • provide personal information.
Protect Yourself from Identity Theft & Fraud • Don’t give out personal • information. • Sign up for the National • Do-Not-Call List: • www.donotcall.gov • or 1-888-382-1222 for landlines. • For cell phones, call from your • personal cp.
Protect Yourself from Identity Theft Fraud and Fraud • Hang up on anyone who tries to threaten or pressure you. • Shred everything with your personal information, even key cards that unlock your hotel room. I’m hanging up!!!
Protect Yourself from IdentityTheft and Fraud • Remove your name from Google’s phonebook. • Go to http://www.google.com/help/pbremoval.html • This will take you to a form that you complete. • Tell the reason why you want to be • removed: Privacy.
Affordable Care Act Fights Fraud • Tougher screenings for health care providers • Keep fraudulent providers out of Medicare, Medicaid and CHIP
Affordable Care Act Fights Fraud • Coordinate with states to share fraud information • Increase penalties for fraud • Recovered $4.1 billion in 2011 (highest ever recovered).
Volunteer Opportunities • Group Presentations • One-on-One Assistance • Distributing handouts • at Senior/Health Fairs Ohio SMP
Where Can I Volunteer? • OSHIIP Events • New Volunteer Trainings • Medicare Check UP Days • Welcome to Medicare • Senior Centers • Places of Worship • Retiree Organizations • Senior Residential Facilities • Anywhere that seniors and/or their caregivers gather.
We Offer Flexibility • Volunteer at times that work for you. • Volunteer at locations of your choice in the State of Ohio.
Benefits of Volunteering • Better understanding of Medicare benefits and protection from Medicare Fraud and Identity Theft through training at no cost to you • Ongoing support and education
Stop Medicare Fraud and ID theft Join our team of volunteers! Contact Jane1-800-488-6070, email@example.com
Important Phone Numbers • Pro Seniors can provide free legal advice. • 1-800-488-6070 www.proseniors.org • OSHIIP can answer your questions about Medicare • 1-800-686-1578
Questions??? The End