Medicare fraud can begin with something that doesn’t feel particularly dangerous: a phone call about a “free” genetic test, an unexpected package containing medical equipment, or a stranger who already knows your name. The stakes became clearer in August when the Centers for Medicare & Medicaid Services announced it had stopped more than $1.6 billion in potentially improper laboratory payments through fraud enforcement actions. According to CMS, the effort included revoking 157 fraudulent lab providers, suspending payments during investigations, recovering overpayments, and referring cases to law enforcement. The agency identified suspicious activity involving services that weren’t provided, medically unnecessary testing, upcoding, and questionable genetic and drug testing. Those cases make these seven Medicare fraud red flags worth recognizing before your Medicare number winds up attached to a claim you never expected.
