Senior Medicare Patrol projects see mixed results

Tuesday, June 7, 2016

WASHINGTON – Senior Medicare Patrol projects report $2.5 million in expected recoveries for Medicare in 2015, compared to $660,829 in 2014, a 282% increase, according to a June 3 report from the Office of Inspector General. These projects did not report any expected recoveries for Medicaid in 2015, compared to $504 in 2014. The Senior Medicare Patrol projects also reported $35,059 in savings to Medicare beneficiaries and others in 2015, compared to $80,228 in 2014, a 56% decrease. These projects also reported $21,533 in cost avoidance for Medicare, Medicaid, beneficiaries and others in 2015, compared to $200,598 in 2014, an 89% decrease. While the Senior Medicare Patrol seemed to be less successful in certain areas, the OIG believes the projects may not be receiving full credit for savings attributable to their work. “It is not always possible to track referrals to Medicare contractors or law enforcement from beneficiaries who have learned to detect fraud, waste and abuse from the projects,” the report states. “In addition, the projects are unable to track the potentially substantial savings derived from a sentinel effect, whereby Medicare beneficiaries’ scrutiny of their bills reduce fraud and errors.”