Health care fraud and abuse schemes
Be aware of these known schemes
It’s an unfortunate fact that new health care fraud and abuse schemes are constantly occurring. Thankfully, these types of fraud and abuse are also consistently being uncovered. You can protect yourself and your family by staying informed. Review the current known fraud and abuse schemes below to learn more.
It's unfortunate that during times of crisis, such as the Coronavirus pandemic, that people who want to scam others may tap into fears and anxieties and increase their fraudulent activities.
Be on alert for fraud
The only way to obtain a valid vaccination card (or other proof of vaccination, e.g. ‘vaccination passport’) is by receiving an approved COVID-19 vaccine from an approved health professional.
If someone calls, texts, or emails you promising access to the vaccine for a fee, don’t share your personal or financial information. Here's what to know:
- No one should ask you to pay to put your name on a list to get the vaccine
- No one should ask you to pay to get early access to a vaccine
What to do
- You will not be asked for money, personal, medical or financial information to enhance your access to a COVID-19 vaccine. Always refer to your state or local health department's website.
- Be cautious of any unsolicited phone calls offering COVID-19 tests, supplies or vaccines. If you receive a suspicious call, hang up immediately.
- Do not respond or click on any hyperlinks in texts or emails in regard to COVID-19 from unknown numbers or emails.
- Be diligent about reviewing your health records and claim information for services and/or treatment that you did not request or receive.
- Treat your insurance card as you would a credit card.
- Report the concern
To understand the vaccination plan for your area, visit your state or local health department's website.
Fraud and abuse schemes via unsolicited phone calls or door-to-door solicitors have become more common in recent years. Here are common ways you may experience this kind of fraud and abuse:
- Callers or salespersons pretend to be representatives from Medicare or an insurance plan
- They offer no cost or low cost medical items and attempt to obtain insurance identification or other personal information from you through false representation
- Unfortunately, they are insistent, and may use intimidation and scare tactics
What to do
- Do not give out any personal information
- Do not give your health insurance identification numbers
- Report the concern
Millions of durable medical prescriptions have been filed falsely in a siginifcant fraud and abuse scheme. Here's how this type of fraud and abuse typically happens.
- Medical equipment companies obtain prescriptions for medically unnecessary orthotic braces and use them to fraudulently bill Medicare
- You may be contacted via phone or door-to-door solicitors who may try to obtain your health insurance number or personal information in an attempt to file a false claim
What to do
- Do not give out any personal information
- Do not give your health insurance identification numbers
- Report the concern
It's important to watch out for DNA scams. This involves scammers offering cheek swabs for genetic testing. It's actually an attempt to obtain health insurance information.
What to do
- Don’t accept a kit unless your doctor ordered it
- Check with your doctor, who you know and trust, to approve any request for genetic testing
- Report the concern
Report suspected fraud or abuse
- Call the number on your ID card
- Call 1-844-359-7736 if you're a UnitedHealthcare member
- Call 1-800-MEDICARE if you're a Medicare member
- Report suspicious callers to the Federal Trade Commission
