Fraud, Waste and Abuse
Committing fraud or abuse is against the law. Medicare fraud wastes a lot of money each year and results in higher health care costs and taxes for everyone. There are con artists who may try to get your Medicare Number or personal information so they can steal your identity and commit Medicare fraud. It is important to remember that Medicare, or someone representing Medicare, will never contact you for your Medicare Number or other personal information unless you’ve given them permission in advance.
Mercy Care Advantage staff will never contact you to ask for your Medicare Number or other personal information.
Fraud means any deliberate and dishonest act committed with the knowledge that it could result in an unauthorized benefit to the person committing the act or someone else who is not entitled to the benefit. Examples of fraud include the following:
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Abuse can mean that providers take actions resulting in needless costs to Medicare. These are practices that are inconsistent with accepted sound fiscal, business, or medical practices, and result in an unnecessary cost or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care. Examples of abuse include the following:
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You can help protect yourself and Medicare against fraud by taking the following actions:
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Reporting
If you think a person, member or provider is misusing the program, please let us know by contacting the Mercy Care Fraud Hotline: 1‑800‑810‑6544.
You can learn more about Medicare related fraud, at https://www.medicare.gov/forms-help-resources. The reporting fraud and abuse section of the website has helpful information and tips to help you better understand how to prevent and spot suspected fraud and abuse. You can report suspected Medicare fraud in any of these ways:
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Last Updated: 12/20/2019