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Resources
How to Report Potential Error, Fraud, and Abuse
The vast majority of health care providers are honest. However, the activities of a few unscrupulous individuals result in wasted funds for the Medicare and Medicaid programs, and a loss of quality of care for yourself or loved ones.
It is in your best interest and that of all citizens to report suspected error or fraud. Health care error, fraud, and abuse, whether against Medicare or private insurers, increases everyone's health care costs, much the same as shoplifting increases the costs of the food we eat and the clothes we wear. If we are to maintain and sustain our current health care system, we must work together to reduce costs.
If you identify or suspect what you think may be an error, call your health care provider and describe the problem. If you’re not satisfied with the response you get or if you are not comfortable calling your provider directly, call your local Senior Medicare Patrol project. The telephone number can be found in the directory at the bottom of this page.
Before contacting the Senior Medicare Patrol Project in your state, carefully review the facts as you know them and as shown on your Medicare statement. Write down:
- The provider's name and any identifying number you may have.
- The item or service you are questioning.
- The date on which the item or service was supposedly furnished.
- The amount approved and paid by Medicare.
- The date of the explanation of benefits.
- The name and Medicare number of the person who supposedly received the item or service.
- The reason you believe Medicare should not have paid.
- Any other information you may have showing that the claim for the item or service should not have been paid by Medicare.
For more information, contact the Senior Medicare Patrol Project located in your state.
State/Local Contact Information
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