December 29, 2004

 

Beware Impostors Claiming To Be Medicare Employees

The Centers for Medicare & Medicaid Services (CMS) has issued a notice informing physicians that Medicare is aware of an organized group who is representing themselves as either a Medicare Fraud Investigator; or a Medicare employee from the enrollment, claims or audit units.  These callers tell the physician, or office personnel, that the Medicare computer system has had a malfunction and they need to update lost information.  The callers may also say they need to update the physician’s provider record.  They then request via telephone or fax the following information:

• Copy of physician’s drivers license;
• Copy of physician’s social security number (SSN);
• Unique Physician Identification Number (UPIN);
• Verification of education;
• Verification of practice location;
• Copy of physician’s medical license;
• Copy of patients' charts for a specific period of time.

Once the impostors receive this information, they falsify enrollment data using the physician’s name and request a change to their practice locations, telephone numbers and payment addresses.  

CMS has not suffered any computer system malfunction and is not calling physicians requesting the above information be provided.  If you should receive such a call, please try to verify the telephone number of the caller, and immediately notify your Medicare carrier that you suspect fraud.

"CMS is committed to protecting all Medicare providers/suppliers and to ensuring that only those qualified make changes to enrollment data.  We believe that with your help we can target those unscrupulous individuals that are looking to take advantage of you and the Medicare trust fund.”