top of page

How To Spot, Prevent And Report Medicare Fraud

A large chunk of the blogs posted, here on the Allegiant Experts Blog, cover stories of health care fraud. Sadly, there are far too many occurrences of said fraud to comprehensively cover them all each and every week. However, we feel that by bringing some light to an unfortunate truth about our nation – that health care fraud is a nationwide epidemic – we can do more to limit it.

The key, of course, is to enlighten the public on how to spot health care fraud so that it can be reported. In a special to the Miami Herald last week, Shayne Benowitz offered up some important tips on how to spot, prevent and report Medicare fraud. He highlights the fact that, this past June, the Department of Justice and United States Attorney’s Office revealed that the Medicare Fraud Strike Force successfully performed the nation’s largest ever healthcare fraud takedown.

“The charges and arrests involved 601 people, including doctors and other licensed medical professionals, spanning 58 federal districts responsible for $2 billion in false billing,” details Benowitz, “These fraudulent schemes involved home healthcare, substance abuse treatment, lab testing and pharmacy fraud, including the distribution of illegal opioid prescriptions.”

South Florida owns a very unflattering title.

Benowitz points out that the DoJ’s announcement included no less than 124 people and $337 million in false billing in the Southern District of Florida alone. In fact, the region happens to be the leader in health care fraud indictment and seizures. Michael Sherwin is the assistant U.S. attorney in the Southern District of Florida. “Other districts learn how to prosecute these cases from us,” he is quoted as saying in the article.

The Medicare Fraud Strike Force was founded in 2007 to target all types of health care fraud. Medicare has received the most attention because of its massive list of beneficiaries. “Today, 59 million people, or roughly 15 percent of the U.S. population, are enrolled in Medicare and that number is expected to grow to 79 million by 2030,” says Benowitz.

How can you spot Medicare fraud?

The first step is to take a close look at each of your bills. It’s important to pay careful attention to what is on your bill so that you can detect errors. After reviewing your claims, you should follow up with your health care provider for clarification. If you notice anything suspicious, you are encouraged to report it to the Medicare hotline at 1-800-MEDICARE.

How can you prevent Medicare fraud?

According to Sherwin, it’s not much different from credit card fraud or identity theft. It’s vital that you protect your personal information. “If someone calls you on the phone and says they’re a doctor from a clinic and they need your credit card number, your banking information, your Social Security number, your Medicare number, that’s a red flag,” he warns, “Hang up. That’s confidential information that should only be shared with your medical provider [in person].”

How do you report Medicare fraud?

There are a number of sources you can use to report Medicare or health care fraud. In addition to the Medicare hotline, you can also contact the Office of the Inspector General by calling 1-800-HHS-TIPS. You can also fill out an online form by visiting

Are you a lawyer currently trying a health care fraud case?

Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help you. Call us at 407-217-5831 or email us at

2 views0 comments


bottom of page