Medicare Takes Aim at Medical Identity Theft

Criminals are increasingly targeting people age 65 or older for personal identity theft. In 2014 alone, there were 2.6 million such incidents among seniors, according to the Department of Justice.

A growing offshoot of identity theft is healthcare fraud, which can result when someone unlawfully uses another person’s Medicare number. Medical identity theft can lead to inaccuracies in medical records, which in turn can result in delayed care, denied services and costly false claims. 

That’s why Medicare works with the Department of Justice, taking aim squarely at would-be thieves. In the largest law enforcement action against criminals fraudulently targeting the Medicare, Medicaid and Tricare programs, 412 people around the country, including 115 doctors, nurses and other licensed medical professionals, were charged in 2017 with bilking U.S. taxpayers out of $1.3 billion.

The next big fraud-fighting push is well underway -- and its focus is protecting the personal information of senior citizens by removing their Social Security numbers from Medicare cards.

People with Medicare don’t need to take any action to get a new Medicare card. Beginning in April, 2018, the Centers for Medicare & Medicaid Services (CMS) will mail out newly designed Medicare cards to the 58 million Americans with Medicare. The cards will have a new number that will be unique for each card recipient. This will help protect personal identity and prevent fraud because identity thieves can’t bill Medicare without a valid Medicare number. To help with a seamless transition to the new cards, providers will be able to use secure look up tools that will support quick access to the new card numbers when needed. 

Healthcare fraud drives up costs for everyone, but healthcare consumers can be an effective first line of defense against fraud. Follow these tips to help protect yourself:

Do

• Treat your Medicare number like a credit card.
• When the new card comes in the mail next year, destroy your old card and make sure you bring your new one to your doctors’ appointments.
• Be suspicious of anyone offering early bird discounts, limited time offers or encouraging you to act now for the best deal. That's an indicator of potential fraud because Medicare plans are forbidden from offering incentives.
• Be skeptical of free gifts, free medical services, discount packages or any offer that sounds too good to be true.
• Only give your Medicare number to doctors, insurers acting on your behalf or trusted people in the community who work with Medicare, like your State Health Insurance Assistance Program (SHIP).
• Report suspected instances of fraud.
• Check your Medicare statements to make sure the charges are accurate.

Don't

• Don’t share your Medicare number or other personal information with anyone who contacts you by telephone, email or approaches you in person, unless you’ve given them permission in advance. Medicare will never contact you uninvited and request your Medicare number or other personal information.
• Don’t let anyone borrow or pay to use your Medicare number.
• Don't allow anyone, except your doctor or other Medicare providers, to review your medical records or recommend services.
• Don't let anyone persuade you to see a doctor for care or services you don't need.
• Don't accept medical supplies from a door-to-door salesman.

Learn more about how you can fight Medicare fraud at Medicare.gov/fraud, or call 1-800-MEDICARE (1-800-633-4227). You can also visit a local SHIP counselor, who can provide free, one-on-one, non-biased Medicare assistance.

With a common sense approach to protecting health information, senior citizens can be effective partners in fighting Medicare fraud.

By Seema Verna, CMS Administrator

Sponsored by Centers for Medicare & Medicaid Services