The Service Tree lists all services in "branched" groups, starting with the very general and moving to the very specific. Click on the name of any group name to see the sub-groups available within it. Click on a service code to see its details and the providers who offer that service.
Insurance Fraud Reporting
Programs that provide a hotline, website or other mechanisms that persons with Medicare and the public at large can use to report health care providers or beneficiaries who make false statements or representations which result in an unauthorized payment by the Medicare program to themselves or another. Also included are organizations that accept and investigate reports about fraudulent entities that misrepresent themselves as approved Medicare Part D Prescription Drug Plans; approved plans that use aggressive marketing tactics, discriminate against a beneficiary (e.g., prevent them from signing up for a plan based on their age, health status, race or income), entice beneficiaries to enroll in a more costly plan than they require, or erroneously charge beneficiaries for medication provided under the plan they have selected; or pharmacies that provide a different drug than the one prescribed by the physician. Examples of Medicare fraud include incorrect reporting of diagnoses or procedures to maximize payments; billing for services, medical supplies, equipment or medications not provided; misrepresentation of the dates and descriptions of services or medications provided, the identity of the recipient or the individual furnishing services; and billing for noncovered or nonchargeable services as covered items. Also included are programs that provide consumer education, counseling and assistance with the objective of helping people identify instances of fraud.
Workers Compensation Fraud Reporting
Programs that provide a hotline, website or other mechanisms that the public can use to report to cases of suspected fraud involving claimants, employers, insurance company officials, officials of third-party administrators, insurance agents, lawyers, health care providers, and vocational rehabilitation providers who have lied to obtain a benefit through the Workers Compensation program or to prevent a benefit from being awarded. Examples of this type of fraud include employers who have lied about the nature of the work involved, the number of employees or their salaries in order to receive lower Workers Compensation insurance rates; employers who have not obtained Workers Compensation when required to do so; employees who file Workers Compensation claims for injuries that did not occur; employees who obtain benefits as a result of lying about their ability to work or income from other sources; and health care providers or lawyers who inflate their bills or bill for treatment of or services related to nonwork-connected injuries.