LessonScams IntermediateScam Alert

Medicare and Healthcare Fraud

Learn about common Medicare fraud schemes — genetic testing scams, equipment billing fraud, upcoding, and medical identity theft — and how to protect yourself in Hawaii.

Intermediate8 min read

Lesson content

Summary

Healthcare fraud costs billions every year. Criminals often target Medicare beneficiaries, including kupuna in Hawaii.

Common Fraud Schemes

Genetic Testing

Offers "free" genetic testing to obtain your Medicare number. The tests may be unnecessary and the results may never be used for your care.

Durable Medical Equipment

Billing Medicare for equipment you never received, such as braces, wheelchairs, or diabetic supplies.

Upcoding

Charging for more expensive medical services than were actually provided.

Medical Identity Theft

Someone uses your Medicare number to receive healthcare. This can place incorrect information into your medical record, which may affect your future care.

Prevention

Keep a Personal Health Care Journal. Compare it with your Medicare Summary Notices and Explanation of Benefits statements. Report anything that does not match.

Hawaii Resources

  • Senior Medicare Patrol (Hawaii): (808) 586-7281 or 1-800-296-9422
  • Hawaii SHIP: (808) 586-7299

Step-by-step actions

  1. Keep a Personal Health Care Journal of appointments, tests, and equipment.
  2. Compare your journal with Medicare Summary Notices and Explanation of Benefits.
  3. Report mismatches to Senior Medicare Patrol at (808) 586-7281.
  4. Never give your Medicare number to someone who calls you unexpectedly.
  5. Contact Hawaii SHIP at (808) 586-7299 for Medicare counseling and help.

Hawaii Medicare Help

  1. Senior Medicare Patrol: (808) 586-7281
  2. Hawaii SHIP: (808) 586-7299

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