How It Costs You: Medicare Fraud in Nursing Homes

Medicare fraud is currently running rampant, and American taxpayers are left holding the bag. The United States Justice Department recovered more than $2.6 billion in 2019 from lawsuits involving healthcare fraud and false claims. Perhaps more alarming, those who create and submit these false claims—drug and medical device manufacturers, insurers, hospitals, pharmacies, hospice organizations, laboratories, and doctors—often endanger the lives of the elderly patients that they are supposedly caring for.

Some of the largest perpetrators of Medicare fraud are nursing homes. When engaging in Medicare fraud, nursing homes provide patients with services that they do not need and bill Medicare for the reimbursements. In one particularly egregious case, a nursing home within a national chain billed Medicare for physical therapy, occupational therapy, and speech therapy for a single patient all in the same day. Meanwhile, the patient, who was ninety-two years old and very ill, died the next day.

If you have a loved one receiving care in a nursing home, it is important that you do your part to prevent Medicare fraud. There are several things that you can do. First, keep a record of all health care services your loved one receives. Keep a special calendar in order to record the dates of services rendered. Within your calendar, save any receipts you receive from the care provider. Then, when your loved one gets statements concerning his or her care, cross-check your records to ensure that there are no mistakes.

Importantly, if something seems awry, do not be afraid to ask questions concerning the care your loved one is receiving and the reimbursement practices for the care. Remember that your loved one has a right to information concerning anything that was billed to Medicare on his or her behalf.