Medicare Fraud: How to Protect Yourself and Others

Friday, November 04, 2011

GoLocalProv Health Team

medicare fraud

Open enrollment season is high-risk fraud season: how to be safe

Open enrollment season means many things, and one of them is that beneficiaries can change their Medicare health plans and prescription drug plans. According to the Centers for Medicare and Medicaid Services (CMS), fraud attemps increase during this season.

To protect Rhode Islanders, the Rhode Island Department of Human Services, Division of Elderly Affairs (DEA) is looking for volunteers to help fight Medicare fraud in Rhode Island. Individuals are being sought to work with the RI Senior Medicare Patrol (SMP) Program to alert state Medicare beneficiaries throughout RI about protecting themselves and others from fraud.

Keeping the population keenly aware

“It is our goal to continue to keep our RI Medicare population keenly aware of the possible fraudulent activity that could negatively affect them, and importantly, to arm them with the education and tools to combat it,” said Catherine Taylor, Director of RI’s Division of Elderly Affairs. “Our critical volunteer core helps do just that.”

Each year, billions of American taxpayers’ dollars are wasted on improper payments to individuals, organizations, and contractors, according to the White House Office of the Press Secretary. These are payments made in the wrong amounts, to the wrong person, or for the wrong reason. In 2009, improper payments totaled $98 billion, with $54 billion stemming from Medicare and Medicaid.

Since 1997, more than 25.3 million people have been reached during community education events, more than 4 million beneficiaries have been educated, and more than 24,400 volunteers have been active, reports the Office of the Inspector General. Total savings to Medicare/Medicaid beneficiaries and other payers attributed to the SMP projects is $106 million.

RI's Senior Medicare Patrol Program

The Senior Medicare Patrol Program in RI features partner agencies statewide where Rhode Islanders can visit or call if they suspect fraud. Volunteers help check paperwork such as Medicare notices and billing – looking for errors and discrepancies. Both one-on-one counsel and general education sessions are available via RI’s six SMP program partners: THE POINT (462-4444); Tri-Town Community Action Agency (351-2750); South County Community Action Agency (789-3016); the East Bay Community Action Program (437-1000); the West Bay Community Action Program (732-4660); and Child and Family Services of Newport County, Inc. (848-4185). In RI, the Office of the Inspector General reports, there were 7,587 simple inquiries about Medicare fraud in 2010 and over 1,400 people were reached via community outreach education events.

How you can stop Medicare fraud in RI

The Division of Elderly Affairs says It’s as easy as 1-2-3:

·      Protect Your Medicare Number
·      Detect – Read Your Medicare Summary Notice
·      Report Your Concerns

Some fraud prevention tips include:
· Don’t divulge personal information to someone who has initiated contact. Social Security, Medicare, and bank account numbers can be used against consumers, as can information such as the names of individuals’ children or grandchildren.
· Beware of people who say they’re from an organization such as Medicare and need an individual’s Medicare number. If they were from Medicare, they wouldn’t need to ask and they wouldn’t call or visit unless called first.

The Rhode Island Division of Elderly Affairs’ mission is to preserve the independence, dignity, and capacity for choice for seniors, adults with disabilities, families and caregivers. For more information about the RI SMP Program or to volunteer to fight RI Medicare fraud, call 462-0931 TTY 401-462-0740.