The most dangerous piece of mail in your parent's house isn't a bill. It's the envelope that says, in large friendly letters, that it is not a bill. That's the Medicare Summary Notice, and because nothing on it demands money, it gets set on the counter, then moved to the pile, then thrown away with the grocery circulars. Nobody reads a document that isn't asking for anything.
I spent eight years buying houses from families in transition, which meant I spent eight years looking at what was left after a long illness. What I learned is that the money families lose is almost never lost in one dramatic moment. It leaks out through paper nobody opened. I'm on the other side of the table now, and this is the leak I get asked about least and worry about most.
On August 28, 2026, the Centers for Medicare & Medicaid Services announced that it has blocked more than $1.6 billion in potentially improper Medicare laboratory payments. Not billing errors. Labs that were never operational. Tests that could not have been performed on anybody, billed against real Medicare numbers belonging to real people.
Here's the part that should get your attention. If one of those claims was filed under your mother's number, she almost certainly never got a bill for it. Medicare covers clinical laboratory services at zero dollars to her. There's no envelope, no phone call, no red letter. The only place that claim shows up is on a notice she was never going to read, that arrives twice a year, months after the fact.
So the question isn't whether your parent would notice. It's whether you would. And that turns out to be a thing you can fix in about fifteen minutes.
What CMS actually found
Per the CMS press release dated August 28, 2026, the $1.6 billion in enforcement actions breaks down four ways: $732 million in savings from revoking 157 fraudulent lab providers from the Medicare program, more than $500 million in payments halted through 185 payment suspensions arising from an investigation of 600 labs, more than $276 million recouped from 442 identified overpayments that had already gone out the door, and $127 million prevented as a result of 85 law enforcement referrals from a CMS contractor.
CMS says the pattern shows up in three forms: labs billing for medically unnecessary services to beneficiaries who had no established relationship with the ordering provider, labs billing for services that were never rendered at all, and labs billing an up-coded version of a service. The agency named the categories where it sees this most: pathogen detection, high-complexity drug tests, and genetic testing.
The examples CMS published are worth reading slowly. In one, a single individual who owned a consulting company enrolled fourteen laboratories in Medicare fee-for-service and billed more than $24 million for services that could not have been rendered, because CMS found that none of the fourteen labs were operational. Eleven of the fourteen have since had their Medicare enrollments revoked. In another, a Texas lab suspected of billing for services not rendered started billing at the end of February 2026. CMS denied $1.2 million of its claims, the lab changed its billing patterns in early April to get around the controls, and a payment suspension stopped another $150,000 before the provider was revoked that same month.
CMS Administrator Dr. Mehmet Oz put the stakes this way in the release: "When laboratories bill Medicare for tests they never performed, it drains the Medicare Trust Fund and diverts resources away from beneficiaries who need them."
That's true, and it's also the version of the story told from Medicare's side of the counter. From your side of the counter there's a second cost that nobody put a number on: somebody had your parent's Medicare number, and used it, and it worked.
Why nothing about this reaches your parent
Three verified facts explain the whole silence.
Covered lab work costs her nothing. Medicare.gov lists the 2026 beneficiary cost for covered clinical laboratory services as $0. Most Part B services run 20 percent coinsurance after the $283 annual deductible, so a fake physical therapy claim might eventually produce a bill somebody questions. A fake lab panel produces nothing at all.
The paper notice is slow. Medicare.gov states that people with Original Medicare get a Medicare Summary Notice in the mail at least twice a year, and that you'll get it every six months if you received any services in that period. A claim filed in March may not appear on paper until the fall.
The online record is fast. That same agency, same program. Medicare.gov states that in a secure Medicare account you can usually see a claim within 24 hours after Medicare processes it. If your parent has a Medicare Advantage or Part D plan instead, the plan mails an Explanation of Benefits every month there's a prescription, a visit, or a claim.
Six months versus 24 hours. That gap is the entire opportunity, and it costs nothing to close.
The free-test problem, which is the front door
The claims CMS is blocking had to come from somewhere, and the somewhere is usually a person who handed over a number.
The HHS Office of Inspector General publishes a standing consumer fraud alert on exactly this, called Fraud Alert: Genetic Testing Scam. In it, OIG describes scammers offering Medicare beneficiaries "free" screenings or cheek swabs in order to obtain their Medicare information for identity theft or fraudulent billing. OIG names where this happens: telemarketing calls, booths at public events, health fairs, and door-to-door visits. A beneficiary who agrees may get a cheek swab, an in-person screening, or a testing kit in the mail, whether or not a physician ordered it and whether or not it's medically necessary.
Then OIG states the consequence plainly, and this is the sentence to keep: if Medicare denies the claim, the beneficiary could be responsible for the entire cost of the test, which could be thousands of dollars.
So the $0 is conditional. It's $0 while Medicare pays. When Medicare refuses to pay for a test nobody ordered, the invoice has to land on somebody, and it lands on your parent.
Medicare's own fraud booklet, CMS Product No. 10111, tells people to be suspicious of anyone who says the equipment or service is free and they only need the Medicare number for their records, and it specifically lists billing Medicare for genetic tests you don't need as a red flag. The same booklet is blunt about the rest of it: Medicare will never call to sell you anything, and Medicare doesn't send representatives to your home.
Here's why this belongs in a conversation about senior transitions rather than a conversation about crime. The window when a family is most exposed is the window when everything else is happening. A parent's health shifts. New doctors appear, then a home health agency, then an equipment supplier, and that Medicare number gets read aloud over the phone eight times in a month. Mail stops getting opened, because there's suddenly so much of it. The phone gets answered, because half the calls now are legitimate. Isolation goes up. Every condition a fraudulent biller needs, a family in transition supplies by accident.
Fifteen minutes, five steps
1. Set up the online account, today
Go to Medicare.gov and create the beneficiary's secure account, or sit with your parent while they create it. This is the single highest-value step, because it turns a six-month paper delay into a next-day view of every Original Medicare claim. Medicare.gov also lets a person switch to electronic Medicare Summary Notices, which arrive by email for any month with a processed claim instead of on the twice-a-year paper schedule.
2. Get yourself authorized, in writing
If you're the adult child making the calls, 1-800-MEDICARE legally cannot discuss your parent's information with you without written permission. The form is CMS-10106, Authorization to Disclose Personal Health Information. The current version is dated 03/2026. It can be submitted online through the secure Medicare account, or mailed to the 1-800-MEDICARE Written Authorization Department, PO Box 1270, Lawrence, KS 66044. Your parent can revoke it at any time in writing, which is worth saying out loud when you ask, because it makes the request a smaller thing to agree to.
3. Read the claims against a calendar, not against memory
Medicare's fraud booklet recommends keeping a simple calendar of appointments and tests, then comparing it against the statements. Do this once a quarter and you're looking for one thing: a provider name, a date, or a test nobody in the family recognizes. You don't need to know what a CPT code means. You need to know whether your mother saw anybody on March 14.
4. Refuse the kit, and write down who sent it
If a testing kit shows up unordered, HHS OIG says to refuse the delivery or return it to the sender, and to keep a record of the sender's name and the date you returned it. Don't open it and don't use it. The record you keep is what makes a report actionable later.
5. Make the call, and know which number
If you suspect fraud, Medicare.gov directs you to 1-800-MEDICARE (1-800-633-4227). For a Medicare Advantage or Part D plan you can also call the Investigations Medicare Drug Integrity Contractor at 1-877-7SAFERX (1-877-772-3379). The HHS OIG hotline is 1-800-HHS-TIPS (1-800-447-8477), with online complaints at tips.oig.hhs.gov. If your parent's card is lost or you believe somebody else is using the number, CMS says to call 1-800-MEDICARE about that specifically.
And if you'd rather not do any of it alone: the Senior Medicare Patrol exists for precisely this. It's funded by the Administration for Community Living, there's a program in every state, and it gives free one-on-one help to beneficiaries, families, and caregivers reviewing statements and reporting suspected fraud. The locator is at smpresource.org and the national number is 1-877-808-2468. Free, unbiased, nobody selling anything.
The version of this that actually matters
Open Enrollment runs October 15 through December 7, which means a fresh mountain of plan mail is about to land in your parent's house. That's the moment this either gets handled or gets buried for another year.
The family that catches this isn't smarter than the family that doesn't. It's the family where one adult child spent fifteen minutes in September setting up an account and getting a form signed, before anything was on fire. That's the whole difference. You become the person who noticed, which is a much better job than being the person who found out.
The same instinct protects the bigger asset, too. The posture that lets a lab bill $24 million against numbers that belong to real people, unopened mail, an answered phone, and nobody double-checking, is the same posture that gets a signature onto a lowball offer for a paid-off house. Somebody in the family has to be the one who reads things. It might as well be you, and it's easier to start with a Medicare statement than with a purchase contract.
Frequently Asked Questions
How do I know if someone is using my parent's Medicare number?
Check the claims, not the mail. Medicare.gov states that in a secure Medicare account you can usually see an Original Medicare claim within 24 hours after Medicare processes it, while the paper Medicare Summary Notice arrives at most twice a year. Compare each claim against a calendar of actual appointments, and look for a provider, date, or test nobody in the family recognizes. For a Medicare Advantage or Part D plan, check the Explanation of Benefits the plan mails each month there's a claim.
Does my parent pay anything for a lab test billed to Medicare?
Usually nothing, which is exactly why fraudulent lab claims go unnoticed. Medicare.gov lists the 2026 beneficiary cost for covered clinical laboratory services as $0. But the HHS Office of Inspector General warns in its Fraud Alert: Genetic Testing Scam that if Medicare denies a claim for a test that was not medically necessary or not ordered by a treating physician, the beneficiary could be responsible for the entire cost, which could be thousands of dollars.
What should I do if a genetic testing kit arrives that nobody ordered?
The HHS Office of Inspector General says not to accept it unless your physician ordered it. Refuse the delivery or return it to the sender, and keep a record of the sender's name and the date you returned the items. Do not use the swab and do not give the sender a Medicare number. OIG notes these kits are commonly pushed through telemarketing calls, booths at public events, health fairs, and door-to-door visits.
Who do I call to report suspected Medicare fraud?
Medicare.gov directs you to call 1-800-MEDICARE at 1-800-633-4227. If your parent has a Medicare Advantage Plan or Medicare drug plan, you can also call the Investigations Medicare Drug Integrity Contractor at 1-877-7SAFERX, which is 1-877-772-3379. The Department of Health and Human Services Office of Inspector General hotline is 1-800-HHS-TIPS at 1-800-447-8477, and complaints can be filed online at tips.oig.hhs.gov.
Can I check my parent's Medicare claims for them?
Not without permission, and getting it is straightforward. By law 1-800-MEDICARE cannot share a beneficiary's personal health information with anyone else until that beneficiary gives written authorization. The form is CMS-10106, Authorization to Disclose Personal Health Information, current version dated 03/2026. It can be submitted through the beneficiary's secure Medicare.gov account or mailed to the 1-800-MEDICARE Written Authorization Department, PO Box 1270, Lawrence, KS 66044, and your parent can revoke it in writing at any time.
About Ryan Riggins
Ryan Riggins is a senior transition advisor and former house flipper. After 8+ years buying homes from families in transition, he walked away from the cash-buyer side to help families avoid the $50K mistakes he used to profit from. Based in Greensboro, NC. NC Real Estate License #361546, eXp Realty. Founder of Riggins Strategic Solutions and the SeniorSafe app.
Want to see the holes before they cost you? The free Medicare Gap Analyzer walks through what Medicare does not cover in about three minutes, no email required: rigginsstrategicsolutions.com/tools/medicare-gap-analyzer
Want a step-by-step guide? The Senior Transition Blueprint is free, all 20 modules and 69 tools: rigginsstrategicsolutions.com/the-blueprint
Not sure where your family stands? The free Family Readiness Score takes five minutes and shows the gaps across the home, the money, the legal documents, care, and family alignment: rigginsstrategicsolutions.com/tools/family-readiness-score
Need a personalized plan? The Senior Transition Roadmap is free, by application. It adds calls with Ryan and 90 days of email support: rigginsstrategicsolutions.com/the-roadmap
Selling a parent's home? Ryan finds and vets the right local agent for your situation and stays in your corner on the whole sale, at no added cost to your family: rigginsstrategicsolutions.com/in-your-corner
Coordinate the family in one place. SeniorSafeApp keeps daily check-ins, medications, and documents where the whole family can see them: seniorsafeapp.com
Sources
All sources checked September 2, 2026.
- CMS, "CMS Prevents $1.6 Billion in Fraudulent Medicare Laboratory Payments," press release, August 28, 2026. Source for the $1.6 billion total, the $732 million in savings from 157 revoked lab providers, the 185 payment suspensions halting over $500 million from an investigation of 600 labs, the $276 million recouped across 442 identified overpayments, the $127 million prevented through 85 law enforcement referrals, the three billing patterns targeted, the naming of pathogen detection, high-complexity drug tests and genetic testing, the fourteen non-operational labs billing more than $24 million with eleven enrollments revoked, the Texas lab that began billing in late February 2026 with $1.2 million denied and more than $150,000 additionally suspended before revocation, and the quotation from CMS Administrator Dr. Mehmet Oz. https://www.cms.gov/newsroom/press-releases/cms-prevents-1-6-billion-fraudulent-medicare-laboratory-payments
- Medicare.gov, "Costs." Source for the 2026 figures: $0 beneficiary cost for covered clinical laboratory services, the $283 annual Part B deductible, the standard 20 percent Part B coinsurance, and the $202.90 standard monthly Part B premium. https://www.medicare.gov/basics/costs/medicare-costs
- Medicare.gov, "Medicare Summary Notice (MSN)." Source for the MSN arriving in the mail at least twice a year, the every-six-months cadence when services were received, and the electronic MSN option that emails a link for any month with a processed claim. https://www.medicare.gov/basics/forms-publications-mailings/mailings/costs-and-coverage/medicare-summary-notice
- Medicare.gov, "Checking the status of a claim." Source for a claim usually being visible in a secure Medicare account within 24 hours after Medicare processes it, and for Medicare Advantage and Part D plans mailing an Explanation of Benefits each month with a prescription, provider visit, or claim. https://www.medicare.gov/providers-services/claims-appeals-complaints/claims/check-status
- Medicare.gov, "Reporting Medicare fraud and abuse." Source for the 1-800-MEDICARE and I-MEDIC reporting numbers, and for the statements that Medicare will never call to sell anything or visit a home. https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse
- CMS, "Protecting Yourself From Fraud," CMS Product No. 10111. Source for the HHS OIG hotline at 1-800-HHS-TIPS and tips.oig.hhs.gov, the instruction to call 1-800-MEDICARE if a card is lost or a number is being used by someone else, the calendar-versus-statements method, the red flag of a free service where only the Medicare number is needed, the specific warning about genetic tests billed but not needed, and the Senior Medicare Patrol contact information. https://www.medicare.gov/publications/10111-protecting-yourself-from-fraud.pdf
- HHS Office of Inspector General, "Fraud Alert: Genetic Testing Scam." Source for the free screening and cheek swab scheme, the channels used including telemarketing calls, booths at public events, health fairs and door-to-door visits, the instruction to refuse or return an unordered kit and record the sender and return date, and the warning that a beneficiary could be responsible for the entire cost of a denied test, potentially thousands of dollars. https://oig.hhs.gov/fraud/consumer-alerts/fraud-alert-genetic-testing-scam/
- ACL Administration for Community Living and the SMP National Resource Center. Source for the Senior Medicare Patrol being ACL-funded, operating programs nationwide, providing free one-on-one assistance to beneficiaries, families and caregivers, and for the locator at smpresource.org and the national number 1-877-808-2468. https://acl.gov/programs/protecting-rights-and-preventing-abuse/senior-medicare-patrol-smp
- CMS Form CMS-10106 (03/2026), "Authorization to Disclose Personal Health Information Release Form." Source for the written-permission requirement, online submission through the secure Medicare account, the mailing address at PO Box 1270, Lawrence, KS 66044, and the right to revoke in writing. https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms10106.pdf
- Medicare.gov, "Joining a plan." Source for the Medicare Open Enrollment Period running October 15 through December 7. https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
