Medicare fraud is the act of claiming reimbursement for health care services through Medicare to which you're not entitled, often through identity theft or using someone else's Medicare Card number. It may help to think of your Medicare Card like a credit card, and to safeguard it in a similar fashion. One of the ways perpetrators try to gain access to your Medicare account is by calling you and claiming they're with the U.S. Centers for Medicare and Medicaid Services. They may ask for your card number or personal identifying information. But Medicare rarely calls members; and even then, it's typically only in response to your request that they call you back. Other types of Medicare fraud include the following:
Phantom Billing - Medical providers fraudulently bill Medicare for unnecessary (or never performed) procedures.
Upcoding and Unbundling - Insurance companies fraudulently inflate billing amounts through the billing code in order to get additional risk adjustment payments from Medicare.
Fraudulent Patient Billing - Patients work in tandem with providers, who bill their Medicare account for fraudulent services in exchange for kickbacks.