Theft - Fraud Alert
There is a organized group 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
Unique Physician Identification
Verification of education;
Verification of Practice Location;
Copy of Physician's Medical License;
Copy of Patient's Charts for a
specific period of time.
Once they receive this information, they
falsify enrollment data using the physician's name and request a change to
their practice locations, telephone numbers, and pay-to addresses.
The Centers for Medicare & Medicaid Services (CMS) has not suffered any
system malfunction and are not calling providers requesting the
above information be provided. If you should
receive such a call, please try to verify the telephone number of the caller
and contact the Palmetto GBA Fraud & Abuse Hotline at
The 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.
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