Combating Medicare Fraud

January, 30th

Are you on Medicare or a Medicare Advantage plan? Medicare fraud losses in 2017 reached $60 billion, and according to the Center for Public Integrity, Federal health officials made more than $16 billion in improper payments to private Medicare Advantage health plans last year. Montana SMP is a national program funded by the Administration for Community Living, administered in Montana by Missoula Aging Services, that empowers people to prevent healthcare fraud.

According to Modern Healthcare, one in eight Americans have had their medical records in some way compromised. The average cost to rectify that is $13,500 and 200 hours of your time. Medical ID theft is difficult to fix because there is no centralized source that keeps all medical records. The best way to fix it is to keep it from happening in the first place.

So what can people do to combat the medical identity theft and Medicare fraud? The number one deterrent is to read your statements. If someone is billing for services in your name it will show up on your Medicare Summary Notice or Medicare Advantage Explanation of Benefits. If you see something you don’t recognize or understand, call your provider or call SMP. A $9 mistake once returned $1.37 million to Medicare. To find out how, or for help understanding your statements, call your local SMP office in any Area Agency on Aging in Montana at 1-800-551-3191.

Montana SMP is a program coordinated by Missoula Aging Services and partnered with local Area Agencies on Aging. This project was supported by grant #90MPPG0052 from the U.S. Administration for Community Living, Department of Health and Human Services, Washington D.C., 20201. Points of view or opinions do not necessarily represent official ACL policy.

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