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Preventing Medicare Fraud

Preventing Medicare Fraud

At RMHP, we’re committed to preventing fraud, waste, and abuse in Medicare benefit programs. You can help us in this commitment.


How You Can Help Fight Healthcare Fraud

RMHP is committed to preventing fraud, waste, and abuse in Medicare benefit programs, and we're asking for your help. If you think you've seen or been a victim of fraud, please report it to us immediately. Not sure if what you've seen is fraud? We can help you with that, too.

If you think you have been a victim of fraud or identity theft related to your health information or Medicare coverage, let us know.

To report a potential case of fraud in a specific Medicare benefit program, call UnitedHealthcare's dedicated fraud hotline toll-free at 1-877-637-5595, 24 hours a day, 7 days a week. TTY users call 711.

The fraud hotline allows you to report cases anonymously and confidentially and we'll make every effort to maintain your confidentiality. Please note: if law enforcement needs to get involved in the case you report, RMHP and UnitedHealthcare will not be able to guarantee your confidentiality. But remember — we appreciates you coming forward and will not take any action against you for reporting a potential fraud case in good faith.

Examples of potential Medicare fraud:

  • A health care provider — such as a physician, pharmacy, or medical device company — bills for services you never received.
  • A supplier — for example, a medical device company — bills for equipment different from what you got.
  • Someone uses another person's Medicare card to get medical care, prescriptions, supplies or equipment.
  • Someone charges for home medical equipment after it has been returned.
  • A company offers a Medicare drug or health plan that hasn't been contracted by Medicare.
  • A company uses false information to mislead you into joining a Medicare drug or health plan.

Senior Medicare Patrol (SMP) Program

The SMP Program educates people with Medicare to take an active role in detecting and preventing health care fraud and abuse. There is an SMP Program in every state, the District of Columbia, the U.S. Virgin Islands and Puerto Rico.

Find your local SMP Program

Beware of Identity Theft

Remember:

  • No one should call you or come to your home uninvited to sell Medicare products.
  • Medicare plans cannot ask you for credit card or banking information over the telephone unless you are already a member of that plan.
  • In most cases, Medicare can’t call you to enroll in a plan; you must call them.
  • Only give your information to doctors, other providers and plans contracted by Medicare, and to people in the community who work with Medicare, such as your State Health Insurance Program (SHIP) or Social Security.

If you think you've been a victim of identity theft or fraud, you can also call any of these resources:

For more information, request the guide titled "Protecting Medicare and You from Fraud" by calling toll-free 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call toll-free 1-877-486-2048. A customer service representative can answer your questions 24 hours a day, 7 days a week.

How Medicare Protects You

Medicare works with other government agencies and with private companies to keep you safe from fraud.

You also have the right to control when and to whom your personal information is given.

You are protected from discrimination. You can’t be treated differently because of your race, color, national origin, disability, age, religion, or sex. If you think you haven’t been treated fairly for any of these reasons, call the Department of Health and Human Services, Office for Civil Rights for your state, or call toll-free 1-800-368-1019. TTY users, call toll-free 1-800-537-7697. For more information, visit the U.S. Department of Health and Human Services website.

Medicare Beneficiary Ombudsman

An ombudsman is a person who reviews issues and helps resolve them. The Medicare Beneficiary Ombudsman shares information with the Secretary of Health and Human Services, Congress, and other organizations about what works well with Medicare — and what doesn’t.

The ombudsman helps improve the quality of services and care you get from Medicare by reporting problems and making recommendations.

The ombudsman makes sure this Medicare information is available to Medicare Members:

  • Your Medicare coverage.
  • Information for you to make health care decisions.
  • Medicare rights and protections.
  • How you can resolve issues.

The ombudsman reviews concerns through 1-800-MEDICARE, TTY, call toll-free 1-877-486-2048, 24 hours a day, 7 days a week, and through your State Health Insurance Assistance Program. For more information about the Medicare Beneficiary Ombudsman, visit medicare.gov and select Ombudsman.

 

Enroll with RMHP

RMHP is here to help! Here’s how you can enroll in an RMHP Medicare Advantage or Dual Special Needs Plan.

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Choose a plan and enroll online.

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Call 866-568-3706 (TTY:711), and speak to a licensed agent.

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Find a meeting in your community.

 

Medicare Disclaimer

This page was last updated: 10/01/2020. Please call to confirm you have the most up to date information about our Medicare plans.

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Important Disclaimers: RMHP is a Medicare-approved Cost plan. Enrollment in RMHP depends on contract renewal. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare. Other pharmacies, physicians, providers are available in our network. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult http://www.medicare.gov.   Every year, Medicare evaluates plans based on a 5-star rating system.  If you need help finding a network provider, please call 800-346-4643  (TTY 711) or visit www.rmhpMedicare.org to access our online searchable directory. If you would like a provider directory mailed to you, you may call the number above, request one at the website link provided above, or email customer_service@RMHP.org

Multi Language Interpreter Service Information (English)

Multi Language Interpreter Service Information (Espanól)

 

Other Important Information

Let's Find A Medicare Plan That's Right For You

Since 1977, Colorado retirees like you have trusted RMHP to get the most out of their Medicare benefits. Enjoy easy enrollment, flexible options, and a large provider network when you choose RMHP. Let us help you enjoy your retirement.

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