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National media outreach campaign to seniors about preventing Medicare fraud

Posted Mar 17 2011 3:17pm

HHS Assistant Secretary for Aging Kathy Greenlee today announced a nationwide TV and radio campaign to educate consumers about Medicare fraud. Public service announcements (PSAs) aimed at seniors will emphasize the importance of protecting sensitive personal information such as Medicare numbers.

One of the PSAs premiered today at a regional fraud prevention summit in Detroit sponsored by the U.S. Department of Health and Human Services and the Department of Justice. In addition to teaching seniors how to recognize a common scam, the PSA serves to recruit volunteers for the Senior Medicare Patrol (SMP), a program administered by Administration on Aging (AoA) designed to engage seniors in fraud prevention. SMP staff and volunteers conduct outreach to Medicare beneficiaries in their communities through group presentations, exhibiting at community events, answering calls to the SMP help lines and through one-on-one counseling.

“Empowering consumers to prevent fraud is essential in preserving the integrity of the Medicare and Medicaid programs,” said Assistant Secretary Kathy Greenlee. “The new Senior Medicare Patrol media and outreach campaign will protect seniors from fraud and scams. It will also increase the number of dedicated volunteers who are working around the country to protect the Medicare Trust Funds.”

Although national in scope, the PSA campaign will focus intently on 18 states with high fraud rates, seven of which include Health Care Fraud Prevention and Enforcement Action Team (HEAT) Strike Forces: Detroit, Miami, Los Angeles, Houston, Brooklyn, Tampa Bay, Chicago, and Baton Rouge. The remaining 11 states are Arizona, Massachusetts, Maryland, North Carolina, New Jersey, Georgia, New Mexico, Nevada, Ohio, Pennsylvania and Virginia. Each state will receive a customized PSA with a localized call to action directing seniors to in-state SMP toll-free numbers. Additional national distribution will feature a national SMP toll-free number.

Each year, health care systems, both public and private payers, losebillions to fraud, waste and abuse. The Senior Medicare Patrol program works to reduce the incidence of fraud by recruiting and training retired professionals and other senior citizens to recognize and report health care billing errors and suspected instances of fraud. The Centers for Medicare & Medicaid Services (CMS) has recently awarded $9 million in grants to enhance volunteer programs and outreach efforts of SMP programs. SMP programs in states with HEAT Joint Strike Forces received the highest level of funding.

“The valuable partnership between CMS and AoA is a critical complement to the fraud-fighting tools used across HHS, such as claims reviews and investigations,” said Peter Budetti, director of CMS’ new Center for Program Integrity.“We continue to work with and rely on our beneficiaries, who experience these scams firsthand and are the first line of defense – taking actions to prevent as well as detect health care fraud. We at CMS appreciate the efforts of millions of beneficiaries, who have been educated through SMP projects, and their work to reduce fraud, waste, and abuse in Medicare.”

For more information or to view the PSA, please go to

Protect your personal information.

Don’t give sensitive information to someone you don’t know.
Your Social Security, Medicare, and bank account numbers can be used to defraud you.

You also should avoid sending personal information on the phone or over an unsecure Internet connection. Never purchase items from a website that you’ve found from an e-mail link. If you know the name of an organization you want to do business with, go to the website on your own.

Don’t give any sensitive information out over the phone. Beware of people who say they’re from an organization such as Medicare and they need to know your Medicare number. If they truly were from Medicare, they wouldn’t need to ask. Nor would they call or visit your home unless you called them first. Also consider getting on the federal Do Not Call list.

How can I detect fraud and identify errors?

Here are a few simple steps you can take to detect possible fraud.

Keep records of your health care visits, services, and equipment provided, significant lab work, etc. Also, file copies of any bills or notices from insurance companies, doctors, hospitals, pharmacies, etc., as well as canceled checks.

Always review your Medicare Summary Notice or Part D Explanation of Benefits, and compare these notices to your own records and receipts to make sure they are correct.

Look for three things on your billing statement

1) Charges for something you didn’t get
2) Billing for the same thing twice
3) Services that were not ordered by you or your doctor

Is it okay to dispute information on my Medicare Summary Notice or Part D Exploration of Benefits?

Your health benefits are yours, and it is perfectly acceptable to ask questions of your provider or plan if something does not make sense or may be incorrect. You should contact your provider or plan if:

• You do not understand the charges billed
• You do not think you received a product or service that appears on your statement
• You feel a service was unnecessary

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