Senior Medicare Patrol (SMP) empowers and assists Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse. This page will be updated on a regular basis to help Seniors protect themselves from becoming a victim of fraudulent activities. 

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Here are ways you can detect potential fraud:

• Review Medicare statement as soon as it arrives to ensure all of the services listed were actually received.

• Keep a record of medical visits, tests, receipts for services, and equipment received. A Personal Health Care Journal, available from SMP, can help you keep a record of these services.

• Compare your statements to your receipts, records, and Personal Health Care Journal. If you notice any mistakes, or have questions, call your provider or plan with your questions. If you still have questions or need further help, contact your local SMP.

• Medicare’s www.MyMedicare.gov website allows beneficiaries in Original Medicare to view their most recent Medicare Summary Notice (MSN), track claims made on their behalf, and check payment status. Registering for access to Medicare’s free, secure online service allows you to review all bills processed within the past 36 months.

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Below is a list of common areas in which Medicare fraud occurs. If you or a loved one may have been a victim of any of these schemes, contact your California SMP, the OIG Hotline, and/or local law enforcement. Click on each link for more detailed information.

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Ambulance Fraud

Medicare covers ambulance services when they are medically necessary. To qualify for coverage, the ambulance and its crew must meet certain standards...

 

COVID-19 Fraud

Scams related to the coronavirus, also known as COVID-19, are rapidly increasing as the public health emergency develops. Scammers are targeting older adults...

 

Durable Medical Equipment Fraud

Durable medical equipment (DME) and orthotics companies offer a valuable service by providing wheelchairs, surgical supplies, catheters, and... 

 

Genetic Testing Fraud

Scammers are offering Medicare beneficiaries cheek swabs for genetic testing to obtain their Medicare information for fraudulent billing purposes...

 

Home Health Care Fraud

For Medicare beneficiaries to be eligible for home health care services, they must be under the care of a physician. The physician must certify that the beneficiary...

 

Hospice Fraud

Hospice is an important benefit for the Medicare population. Hospice fraud threatens this benefit for all beneficiaries. Scammers are getting beneficiaries to agree to...

 

Medical Identity Theft

Medical identity theft occurs when a beneficiary’s Medicare number is misused, either by a provider, a supplier, or by someone posing as the real beneficiary...

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Medicare Marketing Violations and Enrollment Fraud

Medicare plans cannot conduct unsolicited phone calls to beneficiaries with whom they have no prior relationship...

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Nursing Home Fraud

Skilled nursing facilities play a crucial role in providing therapy and rehabilitation after you or a loved one have suffered a debilitating illness or stroke. After a qualifying stay in the hospital, Medicare beneficiaries...

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Outpatient Mental Health Care Fraud

Providing mental health services in outpatient clinics saves the government and taxpayers a tremendous amount of money. It also allows the patient to...

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Pharmacy and Prescription Drug Fraud 

Pharmacy and prescription drug fraud is a consistent trend in Medicare. Due to the lucrative nature of prescription drug diversion and pharmacy scams...

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Telehealth Fraud 

Due to the recent expansion of telehealth services, and the ease in which this fraud can be committed, criminals are exploiting this new technology...

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