Are you aware of the most common fraud schemes in Medicare?

By Paula Hersey

4/28/2026

Articles & Toolkits

Below is a list of common areas Medicare fraud occurs.

If you or a loved one may have been a victim of any of these schemes, contact your SMP, the OIG Hotline, and/or local law enforcement.

Ambulance Fraud

Medicare will cover an ambulance ride to the hospital to diagnose or treat symptoms of an illness in an emergency. However, Medicare will not cover...

COVID-19 Fraud

As the COVID-19 Public Health Emergency comes to an end, fraudsters are still attempting to bill Medicare for sham tests or treatments and are...

Durable Medical Equipment Fraud

Durable medical equipment (DME) and orthotics companies offer a valuable service by providing wheelchairs, surgical supplies, catheters, and...

Genetic Testing Fraud

Scammers are offering Medicare beneficiaries cheek swabs for genetic testing to obtain their Medicare information for fraudulent billing purposes or...

Home Health Care Fraud

Medicare Parts A and B cover intermittent or short-term home health services. These services must be provided by a Medicare-approved home health...

Hospice Fraud

Hospice is an important benefit for the Medicare population. Hospice fraud threatens this benefit for all beneficiaries. Scammers are getting...

Medical Identity Theft

Medical identity (ID) theft occurs when someone steals personal information – such as a beneficiary’s name and Medicare number – and uses the...

Medicare Card Scams

In 2018, Medicare updated the Medicare card from containing a person’s Social Security number to a random identifier that includes numbers and...

Medicare Marketing Violations and Misleading Marketing

Health insurance companies try to reach people in various ways, like television commercials, radio ads, events, mailings, phone calls, and texts. The...

Nursing Home Care Fraud

Medicare doesn’t generally pay for long-term nursing home care. However, Medicare Part A covers medically necessary, short-term care in a skilled...

Outpatient Mental Health Care Fraud

Medicare Part B covers outpatient mental health services in places such as a doctor’s office or other health care provider’s office, a hospital...

Pharmacy and Prescription Drug Fraud

Medicare drug coverage (Part D) helps cover the cost of prescription drugs; some prescriptions are also covered under Part B. Pharmacy and...

Remote Patient Monitoring (RPM) Fraud

Remote patient monitoring (RPM) is the ability for health care providers to monitor certain parts of a person’s health from their home. Providers...

Telehealth Fraud

Medicare covers telehealth services (also known as teledoc services or telemedicine). This could include medical appointments, therapy,...

Tip Sheets for Printing

This handout includes common Medicare fraud schemes in one document for ease of printing. The schemes included are: Ambulance Cardiac Genetic...

More Information

Federal Trade Commission Consumer Information page
Office of Inspector General Consumer Alerts page