About Fraud

What is Medicare Fraud?

Most doctors, health care providers, suppliers, and private companies who work with Medicare are honest. However, there are a few who aren’t. Medicare is trying harder than ever to find and prevent fraud and abuse by working more closely with health care providers and strengthening oversight. Fraud costs the Medicare Program millions of dollars every year. You pay for fraud with higher health care costs. Fraud schemes may be carried out by individuals, companies, or groups of individuals.

There are a number of signs that might make you suspicious of Medicare Fraud.

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The following are examples of possible Medicare fraud:

A health care provider bills Medicare for services you never got.
A supplier bills Medicare for equipment you never got.
Someone uses another person’s Medicare card to get medical care, supplies, or equipment.
Someone bills Medicare for home medical equipment after it has been returned.
A company offers a Medicare drug plan that hasn’t been approved by Medicare.
A company uses false information to mislead you into joining a Medicare plan.

Medicare fraud affects every American. Not only is waste, fraud and abuse taking critical resources out of our health care system, it contributes to the rising cost of health care for all Americans and harms the short-term and long-term solvency of these essential programs.

Eliminating fraud will cut costs for families, businesses and the federal budget and increase the quality of services for those who need care.

The U.S. Department of Health and Human Services (HHS) and U.S. Department of Justice (DOJ) are working together to help eliminate fraud and investigate fraudulent Medicare and Medicaid operators who are cheating the system.

Attorney General Eric Holder and HHS Secretary Kathleen Sebelius are taking the fight against Medicare and Medicaid fraud to a new level. They have committed senior officials from HHS and DOJ to work together on the Health Care Fraud Prevention and Enforcement Action Team (HEAT).

Learn how to Report Fraud

Learn more about the HEAT Team

Presidential Memorandum Regarding Finding and Recapturing Improper Payments

The Obama Administration is committed to reducing payment errors and eliminating waste, fraud, and abuse in Federal programs. On March 10, 2010, the Administration expanded the use of “Payment Recapture Audits,” a process of identifying improper payments where highly skilled accounting specialists and fraud examiners use state-of-the-art tools and technology to examine payment records and uncover problems such as duplicate payments, payments for services not rendered, overpayments, and fictitious vendors.
Read Presidential Memorandum

Testimony on Health Care Fraud

HHS Deputy Secretary William Corr discussed the Administration’s commitment to combat health care fraud.
Read the Testimony