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Medicare Fraud and Abuse
The Affordable Care Act fights health care fraud, waste, and abuse by providing new tools to prevent and detect fraud, and crack down on individuals who attempt to defraud Medicare. These include increased penalties for criminals, enhanced screening of providers, more coordination between agencies, and expanded efforts to recovery overpayments.
Medicare beneficiaries can also play an important role. Here are some important tips for preventing, detecting and reporting fraud and abuse:
· Treat your Medicare and Social Security numbers like a credit card. Never give these numbers to a stranger.
· Remember, Medicare doesn't call or visit to sell you anything.
· Always review your Medicare Summary Notice and Part D Explanation of Benefits for any errors. If you find errors on either of these documents, contact your medical provider immediately.
· If you are not satisfied after contacting your medical provider, report the questionable charges to Medicare: 1-800-633-4227.
· If you suspect that your medical provider is fraudulently billing Medicare, contact the Department of Health and Human Services Office of the Inspector General Hotline: 1-800-447-8477.
Trained SHINE (Serving Health Information Needs of Elders) volunteers offer free, confidential counseling on all aspects of health insurance to anyone on Medicare. To meet with someone, call your senior center or Counsel on Aging and ask for a SHINE appointment. You can also call the SHINE office at Mystic Valley Elder Services at 781-324-2207 x 164 and leave a message. A volunteer will call you back as soon as possible.
Mystic Valley Elder Services helps elders, adults with disabilities, and their caregivers find the information, assistance, and resources they need. For more information, visit mves.org or call 781-324-7705.
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