NewsLocal News

Actions

Medicare is investigating potentially fraudulent charges for COVID-19 test kits

A spokesperson for the agency said they have identified instances of providers who started billing for an unusually high volume of test kits.
A viewer shared their Medicare statement, which includes the potentially fraudulent charges.
Posted at 7:15 PM, Aug 22, 2023

If you benefit from Medicare services, make sure you take a close look at your statement because the agency has seen an increase in complaints regarding potentially fraudulent charges for COVID-19 test kits.

A viewer shared their Medicare statement, which included the following description: “Provision of COVID-19 test, nonprescription, self-administered and self-collected use, FDA approved.”

The statement lists the following amounts: Money charged to the provider was $200, the amount approved by Medicare was $96, and the amount paid by Medicare was $94.08 dollars.

These charges appear multiple times on different dates: March 22, April 7, April 13, April 16 and April 17.

However, the owner of this account said their physician did not order any tests, and they never approved those charges.

The statement lists other labs as the ones ordering the tests.

KSBY News reached out to the Centers for Medicare and Medicaid Services (CMS) to learn more about these potentially fraudulent charges.

“CMS implemented over-the-counter COVID-19 Test Demonstration to test the efficacy of Medicare covering over-the-counter COVID-19 tests without cost-sharing during the COVID-19 public health emergency (PHE), which ended on May 11, 2023,” said a spokesperson for the Centers for Medicare and Medicaid Services in a statement.

As a result, the spokesperson said the agency has become aware of an increase in test kit complaints and “has identified instances of providers who started billing for an unusually high volume of test kits.”

“CMS has taken immediate action to hold all payments for COVID-19 over-the-counter test kits and has implemented over 100 provider payment suspensions, to date,” added the spokesperson.

In April 2023, the Department of Justice announced criminal charges against 18 defendants for various fraud schemes that allegedly resulted in $490 million in COVID-19 false billings and theft. This included charges against suppliers of COVID-19 over-the-counter tests.

What can you do if you notice an unapproved test kit charge on your bill? Here are some recommendations from the Centers for Medicare and Medicaid Services:

  • Only share your Medicare Beneficiary Identifier (MBI) with a trusted healthcare provider.
  • Report fraudulent charges to 1-800-633-4227.
  • Request a new MBI if yours was compromised.

The Centers for Medicare and Medicaid Services spokesperson said they are investigating these complaints and are collaborating with law enforcement partners on similar COVID-19 fraud schemes.