How do I recognize and report suspected fraud with a home health care agency?
My Patient Guide
Guiding you every step of the way.
Most home health agencies are honest, and use correct billing information. Unfortunately, fraud can occur in the home health industry. It wastes Medicare dollars and takes money used to pay claims. You are important in the fight to prevent fraud, waste, and abuse in the Medicare program.
The best way to protect your home health benefit is to know what Medicare covers, and to know what your doctor has planned for you. If you do not understand something in your care plan, ask questions.
To report suspected home health care or Medicare fraud, call 1-800-447-TIPS (1-800-447-8477) or, send a note to HHSTips@oig.hhs.gov by e-mail. Suspected home health care fraud can also be reported to your Regional Home Health Intermediary (RHHI).
You should look for:
- Home health visits that your doctor orders that you never get.
- Visits by home health staff that are not needed.
- Bills for services and equipment you never get.
- Faking your signature or your doctor’s signature.
- Pressure to accept items and services that you do not need.
- Items listed on your Medicare Summary Notice or Explanation of Medicare Benefits that you do not think you received.
You also should be careful about activities such as:
- Home health services your doctor did not order. The doctor who approves home health services for you should know you, and should be involved in your care. If your care plan changes, make sure that your doctor was involved in making those changes.
- A home health agency that offers you free goods or services in exchange for your Medicare number. Treat your Medicare card like a credit card or cash. Never give your Medicare or Medicaid number to people who tell you a service is free, but they need your number for their records.
Home Health
101
Home Health
Home Health
