Medicare Fraud

Insurance fraud affects everyone by making insurance premiums more expensive. Today's Options^® PFFS is helping the fight against health care fraud by increasing awareness among our members and employees.

We fully support the prosecution of healthcare providers, agents, policy owners, employees, and other groups or individuals who defraud the Medicare system and insurance companies. We aggressively investigate reports of fraud and cooperate with law enforcement officials in their prosecution efforts.

Examples of Medicare Plan Fraud

• Billing for prescriptions that were not dispensed
• Dispensing a generic drug, but billing for a brand name drug
• Prescription drug shorting (i.e., billing for 60 tablets, but dispensing 30)
• Bait and switch pricing
• Routine waivers of coinsurance premiums
• Charging a beneficiary a price over the copay amount
• Adding unauthorized refills to prescriptions
• Drug diversion
• Prescription forging or altering
• Patient has falsely assumed someone’s identity in an attempt to utilize their Medicare benefits

Help Fight Fraud

If you suspect someone of committing insurance fraud against Today’s Options or think you may be a victim, please report the suspicious activity.

Call the Fraud, Waste and Abuse Hotline at 1-800-853-0186. Or e-mail fraud@UniversalAmerican.com.

All calls and e-mails are confidential and may be anonymous.

For more information about insurance fraud, visit www.insurancefraud.org.