Medicare Fraud

They go door-to-door looking for seniors who may need a motorized scooter. They even offer to give them the scooter absolutely free. Those who accept the offer are then asked for their Medicare or Medicaid number. They then bill Medicare or Medicaid for a motorized wheelchair. What is the difference? A scooter can cost $1,800. A motorized wheelchair, $5,000. This practice seems to run rampant throughout much of New Jersey, particularly in apartment buildings catering to seniors.

"It's a popular Medicare/Medicaid scam that costs the government millions of dollars," according to Charles Clarkson, an attorney and Coordinator of the NJ Healthcare Advocate Volunteer Effort (NJ HAVE). "Once seniors unwittingly give out their Medicare or Medicaid number, insurance crooks are off to the races." Combating this problem through education is the goal of the NJ HAVE, under the auspices of Jewish Family & Vocational Service of Middlesex County (, which is part of a federally funded effort called the Senior Medicare Patrol (SMP) program.

"Medicare and Medicaid fraud is a huge problem that the federal government hopes to tackle by teaching Medicare and Medicaid beneficiaries how to avoid becoming victims of fraud, waste and abuse," said Mr. Clarkson. "Everyone has a stake in this because money lost to these practices has an impact on premiums and deductibles and could result in cutbacks to these programs."

NJ HAVE offers the following tips to avoid becoming a victim of Medicare fraud:

  • Always read your Medicare Summary Notice, stamped "This is Not a Bill," that comes in after you receive medical care. Look for three things in particular: charges for services you didn't receive, billing for the same service twice, and services that were not ordered by your doctor.
  • Keep track of your medical services by maintaining a personal health care journal.
  • Then, when you get your Medicare Summary Notice, you can compare the two to determine if you received the services that Medicare is being billed for.
  • Don't give out your Medicare or Medicaid information in person or over the phone until you are sure you can trust the person you are talking to. Treat your Medicare, Medicaid and Social Security number as carefully as your bank accounts and credit cards.
  • Shut the door on anyone claiming to represent Medicare or Medicaid. They will never come to your door uninvited. Remember, too, that Medicare and Medicaid don't sell or endorse any product or service.
  • Shred your Medicare or other health care papers before throwing them away. Crooks go through the trash looking for Social Security numbers and other sensitive data.
  • If someone offers to buy your Medicare or Medicaid number, don't sell it. It's not for sale.
  • If you suspect an error or fraud related to health care, gather the facts and report it.
  • Follow your instincts. If something sounds too good to be true, it probably is!

Additional Information:

  1. Rutgers
  2. Executive Dean of Agriculture and Natural Resources
  3. School of Environmental and Biological Sciences