Medicare Fraud in Florida

Florida is #1 in the United States for Medicare fraud. With 4.6 million Medicare-eligible residents and dense enrollment in Medicare Advantage plans, the state attracts both organized fraud rings and opportunistic scammers.

State for Medicare fraud nationally

4.6M

Medicare beneficiaries in FL

$60B+

National Medicare fraud annually

10%+

Of FL fraud share of national total

Why Florida Leads the Country in Medicare Fraud

Florida combines the largest pool of Medicare beneficiaries (4.6 million) with the most concentrated retirement communities in the country. Add in heavy Medicare Advantage penetration (the privatized version of Medicare where insurance companies receive federal payments), and the result is the country's most fertile ground for billing fraud, equipment scams, and beneficiary-targeted schemes.

Organized fraud rings have operated in Florida for decades. South Florida specifically — Miami-Dade, Broward, Palm Beach — has been the subject of major federal investigations into fake clinics, phantom billing operations, and durable medical equipment (DME) fraud.

The Five Most Common Medicare Fraud Schemes in Florida

1. Durable Medical Equipment (DME) Fraud

A scammer calls a Medicare beneficiary offering "free" back braces, knee braces, diabetic supplies, or CPAP equipment. The beneficiary provides their Medicare number. Equipment may or may not arrive — but Medicare gets billed thousands for items the beneficiary doesn't need or never receives. Reality: Medicare doesn't make outbound calls offering free equipment. Ever.

2. Telehealth Fraud

Pandemic-era telehealth expansion created new fraud vectors. Scammers run brief or fake "consultations" with beneficiaries (often discovered via phone solicitation), then bill Medicare for elaborate services, equipment prescriptions, or genetic testing. Federal indictments in 2024-2025 have targeted multiple Florida-based telehealth fraud rings.

3. Genetic Testing Scams

Scammers at flea markets, health fairs, or via phone offer "free" cancer screening or genetic testing. They take a cheek swab, get the beneficiary's Medicare number, and bill thousands. Tests are often never processed. When they are, results have no clinical value.

4. Medicare Advantage Enrollment Fraud

Aggressive Medicare Advantage marketing — sometimes by licensed agents, sometimes by impersonators — switches beneficiaries to plans without their full understanding. Some schemes enroll people into multiple plans without consent. Result: lost benefits, surprise out-of-network costs, and difficulty switching back.

5. Identity Theft via Medicare Numbers

A stolen Medicare number is a long-term fraud asset. Scammers use them to bill for fake services for years, set up fake clinics, or sell to organized fraud rings. Treat your Medicare number like a Social Security number. Never share over phone, email, or text.

Red Flags That You're Being Medicare-Scammed

Unsolicited calls offering free Medicare equipment, supplies, or services. Medicare doesn't market this way.
Requests for your Medicare number outside a known doctor's office. No legitimate caller needs it.
Pressure to "act now" before a deadline. Real Medicare programs don't expire in 24 hours.
Equipment arriving you didn't order. Keep records; report immediately.
EOB (Explanation of Benefits) statements showing services you didn't receive. Read every EOB. Report discrepancies.
Calls claiming "your Medicare card has expired" and they need to issue a new one. Medicare cards don't expire.

How to Protect Yourself From Florida Medicare Fraud

The single most important protection: Never give your Medicare number to anyone who contacts you. Only provide it to your doctor's office, hospital, or pharmacy when you initiated the visit.

Review every EOB statement. Compare services listed to what you actually received. Discrepancies = report immediately.
Use the official Medicare app for plan changes, not third-party callers or agents.
Document any suspicious contacts. Date, time, phone number, what they said.
Don't accept "free" anything tied to Medicare. Free screenings, equipment, or services from unknown sources are nearly always fraud.
Talk to family. Many Medicare fraud victims realize it months later. Family review of EOBs catches things earlier.

How to Report Florida Medicare Fraud

Where to Report	Contact
Senior Medicare Patrol Florida	1-866-357-6677 The dedicated Florida-specific Medicare fraud line. Free, confidential, trained counselors.
Medicare Fraud Hotline	1-800-MEDICARE (1-800-633-4227)
HHS Office of Inspector General	1-800-HHS-TIPS tips.oig.hhs.gov
Florida Attorney General	1-866-9NO-SCAM For broader consumer protection issues

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Frequently Asked Questions

Why does Florida lead the U.S. in Medicare fraud?

Florida has 4.6 million Medicare beneficiaries — the largest pool in any state. Combined with dense retirement communities and high Medicare Advantage enrollment, this creates the country's most concentrated target population. South Florida specifically has been a federal Medicare fraud hotspot for decades.

Does Medicare call beneficiaries to offer equipment or services?

No. Medicare doesn't make unsolicited calls offering equipment, supplies, services, or anything else. If you receive such a call, it's a scam. Hang up.

What should I do if I gave my Medicare number to a scammer?

(1) Call Senior Medicare Patrol Florida immediately: 1-866-357-6677. (2) Request a new Medicare number through Social Security (yes, you can get one issued in cases of fraud). (3) Watch every EOB statement carefully for the next 12 months. (4) File reports with HHS OIG and Florida AG. (5) Place fraud alerts with credit bureaus.

What's the difference between Medicare and Medicare Advantage fraud?

Original Medicare fraud usually involves fake claims billed directly to CMS for services never rendered. Medicare Advantage fraud often involves aggressive or fraudulent enrollment switches, falsified diagnoses to inflate plan payments, or fake provider networks. Both are widespread in Florida.

Can I get prosecuted for being a Medicare fraud victim?

No. Victims of Medicare fraud are not held responsible for fraudulent billing done in their name without their knowledge. Reporting protects you and helps stop the fraudsters. Don't let fear of repercussions prevent you from reporting.