Medicare Fraud Letter

The Medicare Beneficiary Services receives a lot of Medicare fraud correspondence every year. To reach their customers more effectively, they took an already short letter and made it even shorter and to the point.

• Before

  Investigators at the contractor will review the facts in your case and decide the most appropriate course of action. The first step taken with most Medicare health care providers is to reeducate them about Medicare regulations and policies. If the practice continues, the contractor may conduct special audits of the providers medical records. Often, the contractor recovers overpayments to health care providers this way. If there is sufficient evidence to show that the provider is consistently violating Medicare policies, the contractor will document the violations and ask the Office of the Inspector General to prosecute the case. This can lead to expulsion from the Medicare program, civil monetary penalties, and imprisonment.

• After

  We will take two steps to look at this matter: We will find out if it was an error or fraud.

  We will let you know the result.