Home Health Care Fraud and Billing Scams
Home Health Care Fraud and Billing Scams
You need to make sure that you are being billed for the actual services received, however. A Government Accountability Office report in 2009 revealed that some providers of home health care were exaggerating patients' medical conditions while others billed for unnecessary services or care they did not provide. How does it happen? A recent case in Miami illustrates one way in which home health care fraud happens:
A privately owned company falsified medical documents to make it appear that Medicare beneficiaries needed skilled nursing services to administer insulin injections. Nurses with the group falsified medical tests and patient files to make it look as if the insulin were needed. Others in the group recruited and paid Medicare beneficiaries for their Medicare numbers. The group provided these documents to home health agencies in return for kickbacks and bribes so the agencies could bill Medicare for expensive home health services and insulin therapy.
These phony documents resulted in Medicare being fraudulently billed for about $16 million for services that were neither medically necessary nor, in some cases, received. The defendants in this case are now in prison and have been ordered to pay back Medicare. One of the Medicare beneficiaries who allowed his Medicare number to be used was also sentenced.
What you can do • Don't give your Medicare or insurance to anyone in exchange for a free gift or service. • Give your medical identification numbers only to the medical professionals you know. • Let only your medical professionals review your medical records. • Always check your or insurance to make sure there are no claims for services you did not receive. If you see a claim for a service you didn't get, report it. • Report questionable charges or fraud to Medicare: 800-MEDICARE (800-633-4227) (TTY: 877-486-2049); . • Report suspected health insurance fraud to your insurance company's antifraud department. You should find a number to report fraud on your EOB. • You may also want to contact your state insurance department. You can find contact information at . • Learn more about health care fraud at . Cancel You are leaving AARP.org and going to the website of our trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP.org to learn more about other benefits. Your email address is now confirmed. You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. You can also by updating your account at anytime. You will be asked to register or log in. Cancel Offer Details Disclosures
Watch Out for Home Health Care Fraud
How to avoid or prevent billing scams
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You need to make sure that you are being billed for the actual services received, however. A Government Accountability Office report in 2009 revealed that some providers of home health care were exaggerating patients' medical conditions while others billed for unnecessary services or care they did not provide. How does it happen? A recent case in Miami illustrates one way in which home health care fraud happens:
A privately owned company falsified medical documents to make it appear that Medicare beneficiaries needed skilled nursing services to administer insulin injections. Nurses with the group falsified medical tests and patient files to make it look as if the insulin were needed. Others in the group recruited and paid Medicare beneficiaries for their Medicare numbers. The group provided these documents to home health agencies in return for kickbacks and bribes so the agencies could bill Medicare for expensive home health services and insulin therapy.
These phony documents resulted in Medicare being fraudulently billed for about $16 million for services that were neither medically necessary nor, in some cases, received. The defendants in this case are now in prison and have been ordered to pay back Medicare. One of the Medicare beneficiaries who allowed his Medicare number to be used was also sentenced.
What you can do • Don't give your Medicare or insurance to anyone in exchange for a free gift or service. • Give your medical identification numbers only to the medical professionals you know. • Let only your medical professionals review your medical records. • Always check your or insurance to make sure there are no claims for services you did not receive. If you see a claim for a service you didn't get, report it. • Report questionable charges or fraud to Medicare: 800-MEDICARE (800-633-4227) (TTY: 877-486-2049); . • Report suspected health insurance fraud to your insurance company's antifraud department. You should find a number to report fraud on your EOB. • You may also want to contact your state insurance department. You can find contact information at . • Learn more about health care fraud at . Cancel You are leaving AARP.org and going to the website of our trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP.org to learn more about other benefits. Your email address is now confirmed. You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. You can also by updating your account at anytime. You will be asked to register or log in. Cancel Offer Details Disclosures