To: AAPS MEMBERS
We are passing along this important fraud alert issued by the Florida Medicare Provider website http://www.floridamedicare.com/provider/html/mainPage.asp .
December 28, 2004
Provider Enrollment Fraud Alert
This is to inform you that Medicare is aware of an organized group who is representing themselves as
either a Medicare fraud investigator; or a Medicare employee from the enrollment, claim or audit units.
These callers tell the physician, or office personnel, that the Medicare computer system has had a
malfunction and they need to update lost information. The callers may also say they need to update the
physician’s provider record. They then request via telephone or fax the following information:
• Copy of physician’s drivers license
• Copy of physician’s social security number (SSN)
• Unique physician identification number (UPIN)
• Verification of education
• Verification of practice location
• Copy of physician’s medical license
• Copy of patient’s charts for a specific period of time.
Once the entity receives this information, they falsify enrollment data using the physician’s name and
request a change to their practice locations, telephone numbers, and pay-to-addresses.
The Centers for Medicare & Medicaid Services (CMS) has not suffered any computer system
malfunction and are not calling providers requesting the above information be provided. If you
should receive such a call, please try to verify the telephone number of the caller, and immediately notify
your Medicare carrier that you suspect fraud.
CMS is committed to protect all Medicare providers/suppliers and to ensure that only those qualified
make changes to enrollment data. CMS believes that with your help we can target those unscrupulous
individuals that are looking to take advantage of you and the Medicare trust fund.
To report these calls please contact the toll-free number for First Coast Service Options, Inc.
Medicare Part B Customer Service Center at 1-866-454-9007.
Source: CMS JSM-05154, December 27, 2004