You can also send up to 10 pages describing the incident to HHSTips oig. OIG hopes you find these free educational materials helpful and appreciates your willingness to educate physicians about fraud, waste, and abuse.
They were prepared as tools to assist in teaching physicians; they are not intended to create any rights, privileges, or benefits. In order to avoid billing errors, be sure to pay Avoiding fraud waste and abuse in attention to the payment notice you receive from Medicare or your insurance company.
The following presentation summarizes the five main Federal fraud and abuse laws the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law and provide tips on how physicians should comply with these laws in their relationships with payers e.
This one-time, innocent mistake is not a case of Medicare fraud. Medicare fraud involves doctors or beneficiaries abusing the Medicare system for their own personal gain.
However, in the normal course of medical business, unpleasant things can happen, like billing mistakes and, most alarmingly, Medicare fraud and abuse.
The official information is contained in the relevant laws and regulations. Never give or lend your Medicare card to anyone except your health-care providers.
For physicians who may be unable to attend a live, didactic presentation of the material contained in the Roadmap, we also have provided a narration of the speaker notes to accompany the PowerPoint slides.
You can help detect Medicare billing fraud by carefully reviewing your payment notice. For example, a doctor may use the wrong medical code on a claim submitted to Medicare. Someone besides you uses your Medicare card to receive products or services.
Report Medicare fraud and abuse If you suspect Medicare fraud or abuse, you should report it right away. OIG employees, agents, and staff make no representation, warranty, or guarantee that these compilations of information are error free and will bear no responsibility or liability for the results or consequences of the use of these materials.
Even though the service description sounds right, the wrong code could change how much you pay out of pocket. The TTY number is Medicare abuse, like Medicare fraud, is illegal and punishable to the full extent of the law.
Also, beware of providers who: If you suspect a mistake, immediately talk to your doctor or a staff member about it.
Florida residents only can call or email floridamedicarefraud hp. Fax your report up to 10 pages to Although every reasonable effort has been made to assure the accuracy of the information within these materials, the ultimate responsibility for complying with the Federal fraud and abuse laws lies with the provider of services.
This is the notice you get whenever a doctor or health care provider bills Medicare or your insurance company for a health care product or service. These educational materials are summaries that explain certain aspects of the Federal fraud and abuse laws, but are not legal documents.However, in the normal course of medical business, unpleasant things can happen, like billing mistakes and, most alarmingly, Medicare fraud and abuse.
Medicare fraud is the general term for someone, such as a doctor, knowingly billing the Medicare system for a service or supply that a beneficiary didn’t get. Humana has made a commitment to detecting and preventing fraud, waste and abuse and improve the healthcare system to keep it affordable for everyone.
HEALTH INSURANCE REFORM AT A GLANCE PREVENTING WASTE, FRAUD, AND ABUSE. Reducing waste, fraud, and abuse saves taxpayer dollars and protects the health care investments made by individuals. Avoiding Fraud; Avoiding Fraud. Believe It or Not: Social Security Number Misuse Cases. Posted by: The Communications Division.
DATE: What Is Fraud, Waste, or Abuse? Submit a Report; About This Blog. The Beyond the Numbers blog is a platform for you to engage with the OIG.
Read about what we do and why we do it. A Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse, which is a booklet for physicians' self-study.
A companion PowerPoint presentation (PPT) that we encourage you to use to teach the material contained in the Roadmap. Avoiding Waste and Abuse, and Detecting Fraud Using internal controls to manange Federal-aid programs and projects effectively Companion Resource (PDF, KB): Includes the printable script for this video.Download