Stop Medicare Fraud
Medicare & You – Fraud Section

Fraud occurs when

someone knowingly lies to obtain some benefit or advantage to which they are not otherwise entitled or someone knowingly denies some benefit that is due and to which someone is entitled.

Learn More ⇒ California Department of Insurance on Fraud   

illicit billing scheme to defraud patients and health-insurance providers by routinely charging for unperformed services and unseen patients and exaggerating other treatments,  — count of health-care fraud conspiracy, one count conspiracy to commit money laundering, and six counts of money laundering.   five counts each of health-care fraud and making false statements relating to health-care matters. Mercury News.com  5.25.2016

91 Charged in Federal Health Care Fraud Sting  Kaiser News

Individual Plans – Health Care Reform – Abuse of Special Enrollment Period – Blog Insure Me Kevin.com

File a complaint CA Dept of Insurance  Enforcement Branch Overview

Insurance Journal Fraud Search

Blue Shield – Fraud Unit(800) 221-2367

Report Fraud Waste or Abuse to Blue Cross

www.nicb.org/

Consumer Resources

Medicare Fraud, Waste & Abuse Resources
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More Resources
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Medicare Fraud Resources
Resources

How to Avoid Becoming a Victim of Insurance Fraud
An illustrated brochure describing the warning signs of insurance fraud and some concrete steps you can take to avoid becoming a victim. This brochure contains information helpful to all consumers. It details several types of insurance fraud, such as fake policies, premium fraud, unlicensed agents, unnecessary services, and insurance scams. It also describes how to get your money back and where to complain about insurance fraud.

National Health Care Anti-Fraud Association is the leading national organization focused exclusively on the fight against health care fraud. We are a private-public partnership — our members comprise more than 100 private health insurers and those public-sector law enforcement and regulatory agencies having jurisdiction over health care fraud committed against both private payers and public programs. Established in 2000,

The NHCAA Institute for Health Care Fraud Prevention is a separately incorporated, tax-exempt educational foundation that provides education and training to private- and public-sector health care anti-fraud personnel.

Preventing Credit Card Fraud: Learn How to Protect Yourself
A brochure, available in English and Spanish that describes how crooks steal and use credit cards and card numbers and explains how to protect your credit card and what to do if your card has been stolen.
By Consumer Action.

California Court Website on Fraud & Cyber Crime

Report   Worker’s Compensation Fraud

 

THE INSURANCE FRAUDS PREVENTION ACT

False and Fraudulent Claims  1871-1871.8
Bureau of Fraudulent Claims 1872-1872.96
Insurance Fraud Reporting  1873-1873.4
Motor Vehicle Theft and Motor Vehicle Insurance
Fraud Reporting  1874-1874.81
Insurer Inspections  1874.85-1874.87
Auto Insurance Fraud Crisis Areas  1874.90-1874.91
Arson Investigations .1875-1875.8
Insurance Claims Analysis Bureaus 1875.10-1875.18
Insurer Fraud Investigation  1875.20-1875.23
Deposit of Automobile Insurance Claims                   Information .1876-1876.5
Workers’ Compensation Insurance Fraud Reporting   1877-1877.5
Insurance Fraud Prevention  §1879-1879.8

USC 1347 Federal Law on  Health Care Fraud

Medicare – Part D Fraud – Final Rules – Federal Register

More FAQ’s & Related Pages

Hospital Billing Inconsistencies

 Combating Fraud to keep rates low   InsureMeKevin.com

Our Webpage on Medicare Fraud, Waste & Abuse

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