Be on the lookout for Medicare fraud
News and Views from Rita
Do not go back to what you loved in August, for you will see the near ending of the times you loved. August is the beginning of the end of the year, the times when the lush green leaves start turning to rust and yellow. But if you are a happy outdoorsman and can’t wait to see the first snowdrop, you will be coming into your own, waxing your skis, sharpening your skate blades. Taking your heavy wool sweaters out of mothballs and checking to see where you left your snow shovels.
I am not one of those; I am happily engaged in rounding up the mystery books I have been saving to read all summer.
Absentee ballot voting is easy
I hope you are all registered to vote. If you have given up your most important asset as a citizen, then you can never moan about how badly the government is working, and that is especially true if you don’t like the candidate who won.
This is not true of all states, but in Alaska it is as easy as pie to vote absentee. Just call your election office and ask them to send you an absentee ballot, you get it, fill it out and mail it back. No lines standing at the polls on election date. Voila! You have exercised your privilege as a citizen.
Your vote and your security
Among the very important reasons for seniors to vote is to protect your Social Security. AARP asked both of the presidential candidates what they would do to make Social Security secure for the present and future generations and this is how they replied.
Trump: Have a growing economy, implement a tax reform plan that lowers the rate to 15 percent for corporations, renegotiate trade deals and eliminate fraud, waste and abuse and reduce the size of the federal work force.
Clinton: Fight any attempts to gamble seniors’ retirement security on the stock market through privatization, oppose reducing annual cost-of-living adjustments, oppose efforts to raise the retirement age. Would not cut or privatize Social Security.
Mat-Su nursing homes
Good news for those who live in the Mat-su area. There are two skilled nursing care facilities being contemplated. They are much needed as the nearest facilities are in Anchorage , Valdez, Cordova or the Kenai.
Medicare and fraud
Medicare fraud wastes much money every year and results in higher health care costs and taxes for everyone.
Examples of Medicare fraud:
• A healthcare provider billing Medicare for services you never got
• A supplier billing Medicare for equipment you never got
• Someone using your Medicare card to get medical care, supplies, or equipment
• A company using false information to mislead you into joining a Medicare plan.
You’re the first line of defense against Medicare fraud. You can help by guarding your Medicare number – treat it like a credit card.
If you’ve contacted a provider and you suspect that Medicare is being charged for a service or supply you didn’t get, or you don’t know the provider on the claim, you can:
• Call 1-800-MEDICARE.
• Report it online to the Office of the Inspector General at https://forms.oig.hhs.gov/hotlineoperations/report-fraud-form.aspx
• Call the Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8477). TTY users should call 1-800-377-4950.
Have this information before you report fraud:
• The provider’s name and any identifying number you may have
• The service or item you’re questioning
• The date the service or item was supposedly given or delivered
• The payment amount approved and paid by Medicare
• The date on your MSN
• Your name and Medicare number
• The reason you think Medicare shouldn’t have paid
• Any other information you have showing why Medicare shouldn’t have paid for a service or item
Fighting fraud can pay up to $1,000
You may be eligible for a reward of up to $1,000 if all of these five conditions are met:
• You report your suspected Medicare fraud. The allegation must be specific, not general.
• The suspected Medicare fraud you report must be confirmed as potential fraud by the Program Safeguard Contractor, the Zone Program Integrity Contractor, or the Medicare Drug Integrity Contractor (the Medicare contractors responsible for investigating potential fraud and abuse) and formally referred as part of a case by one of the contractors to the Office of Inspector General for further investigation.
• You aren’t an “excluded individual.” For example, you didn’t participate in the fraud offense being reported. Or, there isn’t another reward that you qualify for under another government program.
• The person or organization you’re reporting isn’t already under investigation by law enforcement.
• Your report leads directly to the recovery of at least $100 of Medicare money.
The incentive reward can’t exceed 10 percent of the overpayments recovered in the case or $1,000, whichever is less. If multiple individuals qualify for a reward, the reward is shared among them.
If you want to know more about the Incentive Reward Program, call 1-800-MEDICARE.
You can contact me if you would like to discuss this issue before you do anything. I will be glad to help you and I will not take any of the reward money!
Rita’s column in the July 2016 edition ran with incorrect contact information (it was my fault - Ed.) for a clinic in Anchorage that accepts Medicare patients. The Lake Otis address was incorrect; the correct address is 5437 E. Northern Lights Blvd. The business is Urgent Care Medical Clinic, 333-8560.
Rita Hatch is an Older Persons Action Group board member and volunteers for OPAG’s Medicare assistance program. Contact her at 276-1059 in Anchorage or toll-free statewide at 1-800-478-1059. Her email address is firstname.lastname@example.org.