Community Champion ⭐⭐⭐

ATTN: Medicare Beneficiaries - A Question

Forum|Forum|1 year ago
February 26, 2025
5 replies
1472 views

Do you routinely monitor and verify your Medicare usage on your Medicare Summary Notices ? If for no other reason than to verify the charge is yours?

S

shamit

Contributor ⭐⭐⭐

Yes. I do. I found a claim that wasn't mine 2 or 3 years ago. I called Medicare and reported it. They said they would look into it. After that it was reported that many Medicare numbers were stolen from the Medicare system and Medicare had paid out a lot o money in false claims mostly for catheter products. That was exactly what the phony claim was on my account. I never used any catheters. It was prescribed by a doctor half way across the country from me who I didn't even know.

Medicare said when they finished investigating a new MSN would be posted with the corrected information. I am still waiting for that to happen. Apparently that company gets to keep that money. So much for stopping fraud.

GailL1Author

Community Champion ⭐⭐⭐

@shamit

Thank you - you did what you should have done. However, it is an ongoing problem - they let the catheter thing go and now they do other things - more expensive things like CGMs and the monitoring. DME is a very big place for these scams. A person I know got a MSN from her DECEASED husband account on a CGM and monitoring to the tune of $ 2700 - Medicare paid it, she reported it but to this day has gotten nothing that showed what happened or if they got the money back. Now how did this get through? Her husband had been dead for months - then out of the blue this current charge pops up with his Medicare number - yes he did have a CGM and monitoring - then the wife decided to check her blood sugar in passing because she had some left over - who know if this had anything to with the scammers???

The other thing I wanted to know was if you got a corrected MSN . Yes, you are like others - report it and never hear another thing.

Are we getting the money back? That seems to be the $ 24,000 question; maybe the 24 million question.

WE now require all DME to be approved by Medicare but then the scammers just use their vendor number and a beneficiary number and they get the money - BUT WAIT - my question is the address that they send the money to - was it recently changed or is it really the address of the DME provider.

I am glad you reported it and I want to hear from others too.

Thank again/

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

S

shamit

Contributor ⭐⭐⭐

@GailL1 It really bothered me because there were 2 catheter claims on the same MSN exactly 1 month about. Each of them was for over $3000+. That is over $6000 in fraud. They paid it and the MSN was never corrected. From what they told me I would assume that meant if they never got the money back. That is not how you stop fraud. I hope you hear from sone others with false claims. This is the big problem. I don't know how they will stop it if they cut staff even more.

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TRL1111

Community Champion ⭐

@GailL1 wrote:
Do you routinely monitor and verify your Medicare usage on your Medicare Summary Notices ? If for no other reason than to verify the charge is yours?

Always. If nothing else, it reminds me why it's worth it to pay extra to have a Plan G because I hate deciphering EOBs. I hate it now, when I'm healthy and usually don't even meet my Part B deductible, and I'm sure I'm going to hate it even more when I get older and crankier AND have more EOBs to deal with.

Plus, yeah, I'm definitely the type to report errors even if they don't cost ME money.

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