Medicare Fraud and Abuse
What Is Medicare Fraud & Abuse?
Fraud occurs when someone intentionally falsifies information or deceives Medicare. Abuse occurs when doctors or suppliers do not follow good medical practices, resulting in unnecessary costs to Medicare, improper payment, or services that are not medically necessary.
A complaint about the quality of care you got from a doctor, hospital, or other provider or facility is not considered fraud or abuse. If you have a complaint about your quality of care, please click here.
If you think a charge is incorrect and you know the provider, you may want to call their office to ask about it. The person you speak to may help you better understand the services or supplies you got. Or, your provider may realize a billing error was made.
If you`ve contacted the provider and you suspect that Medicare is being charged for a service or supply you didn`t get, or you don`t know the provider on the claim, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.