September 12: National Report Medicare Fraud Day
September 4, 2025
Every year on September 12, Americans are asked to fight against Medicare fraud. This is especially important for Medicare Advantage plans. People should look for suspicious activity and report it.
This day, led by The Hesch Firm, LLC, highlights a serious issue. About 10% of all Medicare funds, around $65 billion each year, are lost to fraud.
Origins and Purpose
Founded in 2017 by attorney Joel D. Hesch, this initiative helps people learn about Medicare fraud. Hesch worked at the Department of Justice's whistleblower reward office before starting this project. The goal is to teach the public how to spot and report Medicare fraud correctly.
Hesch's experience led him to create a website and a free e-book. This resource helps whistleblowers understand reporting rules. It ensures they are informed and can qualify for rewards.
Why It Matters
Billions at Stake
● With Medicare spending at around $650 billion per year, the $65 billion lost to fraud severely hampers resources for patients and places an undue burden on taxpayers.
Broad Impact
● Not just a financial issue, fraud undermines clinical integrity, potentially leads to unnecessary or dangerous procedures, and compromises patient privacy through identity theft.
Empowering Whistleblowers
● Reporting fraud through the DOJ’s Whistleblower Reward Program offers substantial incentives: 15–25% of recovered funds, with average payouts around $690,000—and cases must be investigated, with updates provided to the whistleblower.
● Alternatively, reporting directly to CMS may offer a modest reward (around $1,000) but often lacks the same commitment to follow-up.
Common Medicare Fraud Schemes
● Phantom Billing: Charging for services or equipment never provided.
● Upcoding & Unbundling: Inflating costs by using higher-cost billing codes.
● Kickbacks & Self-Referrals: Illegal incentives offered in exchange for patient referrals.
● Identity Theft: Fraudsters using stolen Medicare numbers to submit fake claims.
How to Observe National Report Medicare Fraud Day
Educate Yourself
Dive into resources from The Hesch Firm—grab their free e-book and explore how the DOJ Whistleblower Program works.
Also, check out programs like Senior Medicare Patrol (SMP), which empowers seniors to spot and report fraud.
Review Your Documents
Scrutinize your Explanation of Benefits (EOB) or Medicare Summary Notices (MSNs) for unfamiliar charges or services.
Protect Your Information
Treat your Medicare number like a credit card—keep it safe and share it only when necessary. Beware of unsolicited contacts requesting personal data.
Report Suspected Fraud
● DOJ Whistleblower Reward Program: Apply for a reward and trigger an official investigation.
● CMS: Report via their website or hotline (1-800-MEDICARE) for a smaller potential reward.
Spread the Word
Share posts via #ReportMedicareFraudDay, talk with friends and family, or volunteer with local SMPs to raise community awareness.
A Stronger System Starts with You
By shining a light on fraud, we safeguard the integrity of the Medicare system, protect millions of beneficiaries, and hold abusers accountable. Each report—no matter how small—can catalyze investigations, recover funds, and strengthen the system for future generations.
Mark your calendars: this year—Friday, September 12, 2025—let’s observe National Report Medicare Fraud Day with vigilance, knowledge, and action.
Sources:
https://nationaltoday.com/national-report-medicare-fraud-day/
Disclosure:
This information is an overview and should not be considered as specific guidance or recommendations for any individual or business.
This material is provided as a courtesy and for educational purposes only.
These are the views of the author, not the named Representative or Advisory Services Network, LLC, and should not be construed as investment advice. Neither the named Representative nor Advisory Services Network, LLC gives tax or legal advice. All information is believed to be from reliable sources; however, we make no representation as to its completeness or accuracy. Please consult your Financial Advisor for further information.