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 nursing facility (SNF) within a nursing home under certain conditions. SNFs play a crucial role in providing therapy and rehabilitation after you or a loved one has suffered a debilitating illness or stroke. After a qualifying stay in the hospital, Medicare beneficiaries frequently need some time in a SNF to regain their strength.
However, some unscrupulous facilities (even some associated with national chains) have taken to fraudulent billing.
Report potential nursing home care fraud, errors, or abuse if:
- You see on your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) charges for:
- Services that were not deemed medically necessary by your doctor
- Therapy services or visits that were billed to Medicare but were not provided
- More expensive services than what you were provided
- More therapy than what you were provided
- Skilled nursing services for dates after you were released from the SNF
- You are forced to remain in a SNF until your Part A benefits have expired even though your condition has improved and you wish to change to home health care services
Report Suspected Fraud
To report suspected fraud, click here.