Most doctors, health care providers, suppliers, and private companies who work with public and private health care programs are honest. However, there are a few who are not. Health care fraud occurs when fraudulent billings and medically unnecessary services billed to health care insurers. As Health care fraud is expected to continue to rise as people live longer. This increase will produce a greater demand for Medicare benefits. Health care 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.

What is Health Care Fraud?

• Altered or fabricated medical bills and other documents.
• Excessive or unnecessary treatments.
• Billing schemes, such as:
  • charging for a service more expensive than the one provided.
  • charging for services that were not provided
  • duplicate charges
• False or exaggerated medical disability.
• Collecting on multiple policies for the same illness or injury.

Tips for Avoiding Health Care Fraud

• Never sign blank insurance claim forms.
• Never give blanket authorization to a medical provider to bill for services rendered.
• Ask your medical providers what they will charge and what you will be expected to pay out-of-pocket.
• Carefully review your insurer's explanation of the benefits statement. Call your insurer and provider if you have questions.
• Do not do business with door-to-door or telephone salespeople who tell you that services of medical equipment are free.
• Give your insurance/Medicare identification only to those who have provided you with medical services.
• Keep accurate records of all health care appointments.
• Know if your physician ordered equipment for you.

The Federal Trade Commission, the nation's consumer protection agency, collects complaints about companies, business practices, identity theft, and episodes of violence in the media. Please visit FTC site at https://www.ftccomplaintassistant.gov/ or call them at 1-877-FTC-HELP. For more tips on how to protect yourself from various fraud schemes, we invite you to visit our Fraudsection.