Pennsylvania launches Medicare fraud e-hotline ahead of open enrollment

Pennsylvania has launched a toll-free hotline to help Medicare beneficiaries report suspected fraud, errors and abuse as older adults navigate changes to their health coverage during the program’s annual open enrollment period. 

The Pennsylvania Department of Aging announced the hotline this week through the state’s Senior Medicare Patrol program. Jason Kavulich, secretary of aging, said beneficiaries can call the hotline for free and confidential fraud assistance. 

“The Department of Aging is always looking for additional ways to protect older adults and programs that serve them from fraud, and I am proud of our Education and Outreach team here at PDA who secured federal grant funding to stand up this new program in Pennsylvania,” Kavulich said in a press release Monday.

Medicare open enrollment runs through Dec. 7 and allows beneficiaries to join, switch or drop Medicare Advantage and prescription drugs — making it a prime target for fraudsters and scammers who exploit the confusion surrounding plan changes, new benefits and medical coverage. 

In the announcement, state officials encouraged residents to be cautious about unsolicited calls and offers for free benefits, particularly requests for sensitive information like Social Security or Medicare numbers.

“It’s also important to be extra cautious during the open enrollment period and be wary of unknown calls, avoid discussing Medicare with strangers, and consider reporting unsolicited offers through the new hotline,” added Dan Milloy, who oversees the Pennsylvania Medicare Education and Decision Insight program.

Pennsylvania’s hotline comes amid broader concerns about fraud and improper payments across the nation’s public health insurance programs. 

Supporters of H.R. 1, known as the One Big Beautiful Bill, argue that the law’s provisions target waste, fraud, and abuse. A major policy in H.R. 1 requires the U.S. Department of Health and Human Services to recoup federal dollars when Medicaid payment error rates exceed a three percent threshold — set below recent CMS error rates at six percent.

A March report from the HHS Office of the Inspector General found that state Medicaid Fraud Units, which investigate and prosecute fraud in the Medicaid program, recovered nearly $2 billion in fiscal 2025 through criminal and civil cases. The 53 units, operating across all 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands, reported 1,185 convictions, including 856 for fraud and 329 for patient abuse or neglect. The units recovered $4.64 for every $1 spent by state and federal government, according to the report.

The Centers for Medicare and Medicaid Services has threatened to withhold $2 billion in Medicaid funding annually from the Minnesota Department of Human Services and has already frozen $550 million in deferrals over the past several quarters, including an initial $259 million when the Trump administration announced the crackdown in February 2026. 

In response, Minnesota state officials called for more transparency from the Trump administration into the technology and data used to make those decisions.

“We’ve continued to advance our program integrity work, have met all the Corrective Action Plan requirements from CMS, and still have not heard from Administrator Oz or CMS leadership about a path toward resolution,” Minnesota officials told StateScoop in October. 

In addition to the hotline, Pennsylvania is also directing beneficiaries to its Pennsylvania Medicare Education and Decision Insight program, known as PA MEDI, which provides free independent counseling through the state’s 52 Area Agencies on Aging. 

Counselors can help recipients compare coverage options and determine eligibility for additional assistance, such as PACE and Medicaid savings programs.