How do I report Medicare billing fraud?
Call Medicare to report billing fraud at 1-800-632-4327. If you suspect that a friend or family member—e.g., an aging parent—may have been fraudulently billed, talk with them about the bill.
How do I report a false medical bill?
If you’re registered for your health care under the Affordable Care Act, you can contact their billing department directly. Report the fraudulent billing you’ve experienced, including the name of the medical facility, the supplies, operations, or tests you were incorrectly charged for, and the amount of the charge.
What happens if you fail to report Medicare billing errors?
Failure to report Medicare billing errors to the federal government is a type of Medicare fraud that can get healthcare providers – and their employees – into trouble in two ways: They could be prosecuted for criminal violations, which could result in prison time as well as fines, and they could be sued for treble damages and penalties by ...
Which hospitals have self-reported Medicare billing violations?
For example, Charles Cole Memorial Hospital, a critical access hospital in rural Pennsylvania, self-reported Medicare billing irregularities in 2018, agreeing to pay the federal government $373,547 for the violations.
Is overcharging Medicare illegal?
§ § 3729-3733] The civil FCA protects the Government from being overcharged or sold shoddy goods or services. It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.
What is medical billing abuse?
Abuse is defined as 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.
Which is an example of Medicare abuse?
One example of Medicare abuse is when a doctor makes a mistake on a billing invoice and inadvertently asks for a non-deserved reimbursement. Medicare waste involves the overutilization of services that results in unnecessary costs to Medicare.
What are improper billing practices considered?
When those 'mistakes' are intentionally made by a physician or health care billing administrator, though, they are considered fraud.