OIG finds savings increase from Senior Medicare Patrols

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Wednesday, June 14, 2017

WASHINGTON – Senior Medicare Patrol projects achieved $163,904 in cost avoidance on behalf of Medicare and Medicaid in 2016, up from $21,533 in 2015, according to a study from the Office of Inspector General.

Savings to beneficiaries and others totaled $53,559, up from $35,059, the OIG says.

In 2016, 53 projects had a total of 6,126 active team members who conducted a total of 26,220 group outreach and education events, reaching an estimated 1.5 million people. The projects also had 195,386 individual interactions with, or on behalf of, a beneficiary, according to the OIG.

“We note that the projects may not be receiving full credit for recoveries, savings, and cost avoidance attributable to their work,” the report states. “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. In addition, the projects are unable to track the potentially substantial savings derived from a sentinel effect, whereby Medicare beneficiaries' scrutiny of their bills reduces fraud and errors.”

Senior Medicare Patrol projects receive grants from the Administration for Community Living to recruit and train retired professionals and other senior citizens to recognize and report instances or patterns of healthcare fraud. The OIG has collected performance data on the projects since 1997.