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Protecting Your Practice
From Medicare Fraud
Cited activities include three card monte, ketchup
toss
WASHINGTON, DC--In an effort to curb the tide of
rising healthcare costs stemming from fraudulent Medicare activity, officials
at the Health Care Financing Administration (HCFA) announced new anti-fraud
guidelines at its annual meeting last week.
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HCFA Headquarters, Washington,
DC
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"Medicare fraud is a $250 million per year
industry," said spokesperson Althea Higginson. "We're hoping that,
with these new guidelines, physicians and office staff will be able to spot
it quickly, and take immediate steps to report it."
HCFA's Medicare Fraud And You booklet, available
for free through their toll-free number, details several of the more common
scams:
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Common
Medicare Scams
(Excerpt from "Medicare Fraud And
You")
The Ketchup Toss:
While making rounds, you suddenly feel something hit you from behind.
Someone has thrown ketchup onto your white coat! A Medicare investigator
(or two) comes up to you and says it "came from over there."
You look, while the Good Samaritan(s) clean you up... AND TAKE YOUR
WALLET!
Three Card Monte:
You're walking between exam rooms when you come across a group
of Medicare investigators watching some kind of card game. You go
in closer and see one investigator winning lots of money. As the
lucky "winner" walks away counting his take, you elbow
in for a chance at the free dough. The rules are simple. You bet,
you try to find the red card, you pick, and... YOU LOSE.
You Can Be A Model/Star!:
You're on your way to review x-rays when you're approached by a
gentleman who "works for the Smith modeling agency." (Actually,
a Medicare investigator). He tells you that you have the face he's
been looking for, for his next ad campaign. You blush; he tells
you you'll need a portfolio, and may even give you the card of a
photographer to go to for headshots, and some acting lessons. You
pay $500 for photos, and another $500 for lessons. The next day,
when you go back, you find the only lesson you've learned is that...
YOU'RE NOW OUT $1000.
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According to Higginson, spotting such fraudulent
Medicare activities "isn't easy at first, but once you start to realize
how much you've been gypped all these years, you start noticing these
goons everywhere!"
HCFA urges all healthcare practitioners who suspect
Medicare fraud to contact their local AMA chapter.
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