For Consumers

How to identify and report Medicare fraud and abuse

"I'm extremely grateful for the SHIBA service, I didn't expect to receive such a speedy reply."
~ C.M.
older man smiling

 Important coronavirus fraud alert: Scams related to coronavirus, also known as COVID-19, are also targeting people on Medicare. Check out our Senior Medicare Patrol program (www.smpresource.org) for all types of information and updates on what to watch out for and protect yourself.

We all pay a price for Medicare fraud, abuse and waste! It contributes significantly to rising health care costs. Trust your instincts and learn how to detect fraud.

Do you suspect fraud?

Call our Insurance Consumer Hotline at 800-562-6900 or send us a message.

Watch out for these types of fraud

You are:

  • Billed for services or equipment you didn't receive.
  • Offered free testing or screening in exchange for your Medicare number.
  • Charged for filling out claim forms.

A medical provider:

  • Performs services that exceed what's medically necessary.
  • Offers or accepts referral fees from another provider for the referral.
  • Misrepresents services that are billed to Medicare.
  • Waives the 20% coinsurance or deductible.

Report Medicare fraud and abuse

SHIBA is Washington state's Senior Medicare Patrol (www.smpresource.org) project. We can help clients prevent, detect and report Medicare and Medicaid fraud and abuse. If you have questions or suspect fraud or abuse, call 800-562-6900 and ask to speak with SHIBA.

Medicare fraud-related video library

Protect yourself against Medicare fraud (www.youtube.com)

SMP/OIG COVID-19 health care fraud Q&A (www.youtube.com)