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.
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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 email us.

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 percent 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. 

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