How to Report Medicare Fraud in Hawaii: A Step-by-Step Guide

Medicare fraud is a serious issue that affects everyone by increasing healthcare costs and potentially compromising patient care. In Hawaii, the Senior Medicare Patrol (SMP) Hawaii is dedicated to helping residents prevent, detect, and report Medicare fraud. If you suspect fraudulent activity, follow this step-by-step guide to report it effectively.

Step 1: Recognize the Signs of Medicare Fraud

Before reporting, it’s essential to identify potential fraud. Common indicators include:

• Unfamiliar Charges: Billing for services or equipment you did not receive.
• Duplicate Charges: Multiple billings for the same service.
• Unsolicited Offers: Receiving offers for “free” medical equipment or services in exchange for your Medicare number.
• High-Pressure Tactics: Being pressured to receive unnecessary services or tests.

Step 2: Gather Necessary Information

Collect as much information as possible to support your report:

• Personal Information: Your full name, address, and Medicare number.
• Provider Details: Name and contact information of the healthcare provider or supplier involved.
• Service Details: Dates of service, descriptions of services or equipment billed, and any supporting documents like bills or Medicare Summary Notices (MSNs).

Step 3: Contact SMP Hawaii

Once you’ve gathered the necessary information, reach out to SMP Hawaii for assistance:

• Phone:
  • Oahu: 808-586-7281
  • Toll-Free: 1-800-296-9422
• Email: info@smphawaii.org
• Mailing Address:
  SMP Hawaii
  Executive Office on Aging
  Hawaii State Department of Health
  No. 1 Capitol District
  250 South Hotel St. Suite 406
  Honolulu, Hawaii 96813-2831
• Website: smphawaii.org

Step 4: Report the Fraud

When you contact SMP Hawaii, provide the information you’ve gathered. They will guide you through the reporting process, which may include:

• Completing a Report: Filling out necessary forms detailing the suspected fraud.
• Providing Documentation: Submitting copies of bills, statements, or other relevant documents.
• Cooperating with Investigations: Answering follow-up questions or providing additional information as needed.

Step 5: Monitor Your Medicare Statements

After reporting, continue to review your Medicare Summary Notices (MSNs) and Explanation of Benefits (EOBs) regularly. Look for any unauthorized charges or discrepancies and report them immediately.

Additional Tips to Protect Yourself

• Protect Personal Information: Never share your Medicare number with unverified individuals or organizations.
• Be Skeptical of Unsolicited Offers: Avoid engaging with unsolicited offers for free medical services or equipment.
• Educate Yourself: Stay informed about common Medicare scams and how to avoid them. SMP Hawaii offers educational resources and presentations to help beneficiaries stay vigilant.

By following these steps and working with SMP Hawaii, you can help protect yourself and others from Medicare fraud. Reporting suspected fraud not only safeguards your benefits but also contributes to the integrity of the healthcare system in Hawaii.