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Patients can help reduce Medicare fraud Rallies provide tips on spotting abuse By SUSAN JAY A Medicare bill is the first place where patients can spot fraud and help cut the nation's $23 billion in wrongful charges, say federal and state officials. Several groups including the American Association of Retired Persons, the U.S. Department of Health and Human Services and Oregon Senior and Disabled Services held rallies Wednesday in Medford and across the country to fight Medicare fraud and abuse and to educate consumers on the steps they can take to help. Their point: The more money the government spends on fraudulent bills, the less is available for Medicare beneficiaries and for those who will need it in the future, said Michele Jones, a volunteer with Retired and Senior Volunteer Program, who coordinated the local rally. The above organizations are urging Medicare recipients to review their Medicare bills and to contact their health-care provider or Medicare insurance company if they find questionable charges. If they continue to have questions about items on the bill, they should call the Medicare Fraud Hotline in Oregon, 1-800-232-3020, or the Office of the Inspector General Hotline at 1-800-447-8477. The medical areas where fraud is most common are hospitals, home health care, durable medical equipment, pharmacies and nursing homes. Examples of fraud include providers charging more than once for the same service, charging for services never performed, and providing inappropriate or unnecessary services. In 1996, Oregon had an estimated $196 million in fraudulent Medicare bills, according to the Washington County Area Agency on Aging. Local state officials say there doesn't appear to be a significant problem in Southern Oregon, but that doesn't mean Medicare recipients shouldn't scrutinize their bills and statements for errors. "This situation has gone awry because it was so easy to access services, to send the bills in and get paid for it, with no one challenging it," said Ed Alcantar of Grants Pass, AARP's Southern Oregon coordinator for community operations. He said federal investigators have found the most fraudulent billing activity in medical equipment and home care. Signs of fraud and abuse in these areas include billing for equipment not received, continuing to charge Medicare rental fees after the item has been purchased by the patient and refusing to pick up rental items in order to continue to bill Medicare. Other fraudulent means, not so easily detected by Medicare beneficiaries, include providing low-cost equipment to the Medicare consumer while billing Medicare for high-cost equipment, and providing used equipment while billing Medicare for new equipment. When it comes to home health care, fraud can include billing for services not rendered, billing for services not medically necessary and providing more services or visits than the doctor ordered. Too often, Medicare recipients glance at their statements and, if they don't have to pay, they just file them away. They never review them. But, Alcantar said, if the charges are fraudulent, "we're all paying for it." Read statement, keep number private Medicare patients can take a few simple steps to help stop fraud. Scrutinize your Medicare statement or bill for errors and possible fraud, check with your doctor's office or insurance carrier if you have questions, and call the following toll-free numbers if they you aren't satisfied with the answers. In Oregon, call 1-800-232-3020, or the Office of the Inspector General Hotline at 1-800-447-8477. Other ways to avoid fraud: Never give your Medicare number over the telephone or to people you don't know. Treat it like a credit card number. Never accept Medicare services or medical equipment from anyone who claims they are free. Never allow anyone to persuade you to ask your physician for services you don't need. Never accept medical supplies or equipment from a door-to-door salesperson. Never allow anyone to review your medical records or your prescription medications without your physician's approval. If you need help understanding your Medicare bill or statement or if you have other questions, call the local Senior Health Insurance Benefit Assistance (SHIBA) office, at 779-5257. Mail Tribune Copyright � The Mail Tribune 1999, Medford, Oregon USA