Medicare is a vital program that supports the health and well-being of thousands of kūpuna and families across Hawaii. Unfortunately, Medicare fraud, errors, and abuse continue to grow nationwide—and they affect everyone, not just the individuals directly involved.
Each year, billions of dollars are lost to improper claims. When fraud goes unchecked, it puts the Medicare Trust Fund at risk and can lead to higher out-of-pocket costs, reduced access to care, and compromised treatment quality for beneficiaries. Understanding how fraud happens—and how to prevent it—is one of the most important ways we can protect Medicare together.
Medicare fraud occurs when someone intentionally bills for services that were never provided or charges for services at a higher rate than medically necessary. Fraud can happen in many settings, including medical offices, home health services, and pharmacies. Often, it goes unnoticed unless beneficiaries carefully review their Medicare records.
Common examples of Medicare fraud include:
Billing for services you never received
Duplicate charges for the same service or equipment
Medical identity theft
Durable medical equipment scams
Prescription drug fraud
Home health and hospice fraud
These schemes cost money, undermine trust in the healthcare system, and place beneficiaries at risk.
Medicare fraud does not only harm individuals—it impacts the entire community. When fraud and abuse occur:
The Medicare Trust Fund is weakened
Taxpayer dollars are wasted
Beneficiaries may face higher out-of-pocket costs
Access to necessary healthcare services may be reduced
Protecting Medicare helps ensure it remains strong and available for today’s beneficiaries and future generations in Hawaii.
Every Medicare beneficiary plays a role in prevention. The three key steps are Protect, Detect, and Report:
Protect
Never share your Medicare number, Social Security number, or banking information over the phone
Be cautious of unsolicited calls, emails, or offers claiming Medicare changes or special deals
Detect
Review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) carefully
Look for unfamiliar services, incorrect dates, or duplicate charges
Report
Report billing discrepancies or suspicious activity as soon as possible
Early reporting helps stop fraud and protect others
Education and awareness are powerful tools in the fight against Medicare fraud. Community outreach, counseling, and volunteer efforts help ensure beneficiaries understand their rights, recognize warning signs, and know what steps to take when something doesn’t seem right.
Volunteers and community advocates play an important role by sharing information, supporting outreach efforts, and helping keep Medicare strong across the islands.
Medicare fraud, errors, and abuse affect us all—but together, we can make a difference. By staying informed, reviewing Medicare statements, and speaking up when concerns arise, Hawaii’s community helps protect this essential program.
Protecting Medicare isn’t just about safeguarding benefits—it’s about preserving access, trust, and quality care for our kūpuna, our families, and future generations.
