Spot It. Report It. Stop It.

What Does It Mean to Report Medicare Fraud, Error, or Abuse?

Medicare plays a vital role in helping older adults and people with disabilities get the care they need. But like any large program, sometimes things don’t go as they should. A doctor’s office might make a billing mistake. A supplier could overcharge for equipment. And in some cases, individuals may try to cheat the system on purpose.

That’s why it’s so important to spot it, report it, and stop it. When you share what you see, you help protect your benefits, your loved ones, and the future of Medicare in Hawaii.

What Do We Mean by Fraud, Abuse, or Error?

Not every problem with Medicare is the same. Here’s how to understand the differences:

• Fraud – When someone intentionally deceives Medicare to receive money or services they shouldn’t.
  Example: A provider billing Medicare for services that were never provided.
• Abuse – When providers or suppliers take advantage of Medicare, even if it’s not outright fraud.
  Example: Charging too much for services or ordering unnecessary tests.
• Error – Mistakes in billing or paperwork that lead to incorrect charges or payments.
  Example: A coding mistake on a medical bill.
  (Note: While some errors are truly unintentional, others may be questionable and worth reporting.)

Why Your Report Matters

You don’t need to be an expert or have proof to report something suspicious. If something doesn’t seem right, simply raising the concern is enough. From there, SMP Hawaii—the Senior Medicare Patrol—can review the case and determine whether it’s fraud, abuse, or error.

By reporting, you are:

• Protecting your own Medicare benefits.
• Safeguarding your family and neighbors.
• Ensuring Medicare will be there for future generations.

How to Take Action

If you suspect Medicare fraud, abuse, or error:

1. Document what you notice. Keep records of bills, dates, and any details that seem unusual.
2. Contact SMP Hawaii. Their team is trained to review your concerns and take the next steps.
3. Speak up—even if you’re unsure. You don’t need to decide whether it’s fraud, abuse, or error. Reporting is enough.

Protecting Medicare Protects Us All

When you report suspected problems, you become part of the solution. Together, we can help ensure that Medicare remains a strong and reliable program for Hawaii’s kūpuna, families, and future generations.

➡ Take action today. If you see something, say something. Contact SMP Hawaii to report Medicare fraud, abuse, or errors.

👉 Stay tuned for our next blog, where we’ll share why reporting is not only important for you but also for your loved ones and the entire Medicare program.