INDIANAPOLIS— Fraud, mistakes and abuse cost Medicare an estimated $60 billion each year.
This week marks Medicare Fraud Prevention Week, and WRTV Investigates has learned several types of Medicare fraud are making the rounds in Indiana including:
Nancy Moore, director of Indiana Senior Medicare Patrol, says bad actors steal Medicare numbers on the dark web.
“Medicare numbers are more valuable than social security numbers because if they have all the right documentation, the Medicare claim has to go through, there are rules and regulations around that,” said Moore.
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You will receive a statement or summary notice that shows products or services you never ordered.
In some cases, the products may even show up to your door.
Even though you may not owe anything, Medicare pays for the products/services that were ordered fraudulently using your Medicare number.
It’s a problem WRTV Investigates has been telling you about—phantom billing.
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“One of the best ways to look out for fraud is to read your summary notices, your EOB if you’re on Medicare advantage, or your Medicare summary notice,” said Moore. “If you notice a charge for something you never received or didn’t need. That’s when you should call us to report it.”
You can report it to Indiana Medicare Patrol at 1-800-986-3505.
WRTV Investigates also found an uptick in fraudulent billing to Medicare for urinary catheters.
It’s a problem that is currently costing taxpayers millions and has the potential to increase premiums for Medicare members in the future.
“Most people don’t owe money on these frauds, so the incentive to report is reduced,” said Moore. “But we all need to for our kids and our grandkids so we can protect the integrity of Medicare.”
WRTV Investigates uncovered a similar problem involving charges for unwanted COVID-19 tests.
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If you receive items you did not order or your Medicare Summary Notice lists products you didn’t authorize, you should call 1-800-MEDICARE (1-800-633-4227) to report the situation.
Consumers can also report suspected medical identity theft to the Health & Human Services fraud hotline: 800-447-8477 (800-HHS-TIPS) or the National Insurance Crime Bureau at 800-835-6422.
WRTV Investigates reached out to the Centers for Medicare and Medicaid Services (CMS) to find out what the federal government is doing to address this problem.
We have not yet heard back.
However, the Centers for Medicare and Medicaid Services (CMS) website listed the following actions taken by the agency:
- One durable medical equipment provider was billing Medicare for services to a patient who had died twenty years earlier. CMS stopped payments to the provider and is taking additional action.
- The CMS Fraud Defense Operations Center stopped more than $1 million from being paid to a medical group practice that was billing Medicare for wound care services that were supposedly being performed on patients by the owner, who is a psychiatrist.
- An ongoing scam improperly enrolled four to five million people in subsidized Marketplace coverage, costing taxpayers up to $20 billion. CMS is taking action to root out these improper enrollments.
- CMS began reviewing claims prior to payment for new hospices in 4 high-risk states to stop recent problematic activities among the hospice community.
- CMS removed 18 Medicare providers convicted of a serious crime from the Medicare program to ensure people with Medicare get care from providers who meet our standards.
- Medicaid is refocusing on providing direct health services and will no longer pay for non-medical services. Spending on non-medical services in two state programs grew to nearly $2.7 billion in 2025.
- CMS took steps to protect beneficiaries and taxpayers from waste, fraud and abuse in the Medicare Advantage and Part D programs. These actions will ensure Medicare Advantage continues to offer access to critical services in an efficient, accountable manner.
- The Innovation Center will refocus on reducing program spending while maintaining or improving quality of care to make Americans healthier. After completing a comprehensive and data-driven review of models with this focus, the CMS Innovation Center will end some models early, saving taxpayers almost $750 million.
- CMS reduced funding for the Affordable Care Act (ACA) Navigator program, which only enrolled 0.6 percent of consumers despite netting $98 million in the 2024 plan year. This action could help lower premiums in the individual health insurance market.
