SMP Senior Medicare Patrol Preventing Medicare FraudMedicare Fraud and Abuse

The U.S. Administration for Community Living (ACL) funds the SMP project which empowers and assists Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education.


SMP scam watch banner for Coronvirus (Covid-19)
Scams related to COVID-19 are rapidly increasing. Scammers are targeting older adults and those with serious long-term health conditions who are at higher risk for serious illness from COVID-19. As a result, fraudsters are attempting to bill Medicare for sham tests or treatment, as well as targeting individuals to illegally obtain money or Medicare numbers.

Actions you can take to help prevent fraud:

  • Don't give out your Medicare number to anyone other than your doctor or health care provider.
  • Never give out your Medicare number to anyone who contacts you through unsolicited calls, texts or emails.
  • Don't click on links from sources you don't know which could put your computer or device at risk.
  • Ignore online offers for vaccinations and ads touting prevention products or cures for COVID-19.

Please visit the SMP National Resource Center web page below for tips on preventing fraud and information about Medicare coverage. www.smpresource.org/…/Med…/Fraud-Schemes/COVID-19-fraud.aspx

Call the Alaska DHSS Medicare Information Office with questions at 800-478-6065 or 907-269-3680 (in Anchorage).


'Free' DNA testing used to scam Medicare recipients

States sound alarm about fraudsters urging cancer screenings reported in an article by Katherine Skiba, AARP, April 19, 2019.

Medicare Summary Notice (MSN)

The Medicare Summary Notice is an easy-to-read statement that clearly lists your health insurance claims information. The MSN lists the details of the services you received and the amount you may be billed. These notices are sent by companies that handle bills for Medicare on a quarterly basis, unless you are due a payment check from Medicare. If you are due payment from Medicare, the MSN will be mailed to you as your claims are processed.
The MSN lists all the services or supplies that were billed to Medicare for a 90-day period of time. It is important to check this notice to be sure you got all the services, medical supplies, or equipment that providers billed to Medicare. If you have any questions or if you need an MSN for a particular claim before the quarterly mailing, call the phone number listed in the Customer Service Information box on the front of the MSN. If you disagree with a claims decision, you have the right to file an appeal. Follow the instructions on the MSN to file an appeal.

www.mymedicare.gov

Medicare's free, secure online service for accessing personalized information about your Medicare benefits and services. After you sign in, you can view claims information, get quality information about your providers, create and print an "On the Go" report with information you can share with your healthcare providers, view and manage your drug list and pharmacy information, and view your current and upcoming preventive services calendar.

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Be aware of ongoing scams 

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