SMP reports recoveries, hampered by COVID-19

WASHINGTON – The Senior Medicare Patrol (SMP) projects reported $153,812 million in expected Medicare recoveries for 2022 but cautions that COVID-19 continues to limit its activities, according to a new report from the Office of Inspector General. In 2022, the 53 reporting SMP projects had a total of 5,365 active team members who conducted a total of 18,274 group outreach and education events, reaching an estimated 1 million people. In addition, the projects had 246,722 individual interactions with, or on behalf of, a Medicare beneficiary. Over half of the recoveries for 2022 came from one project that identified a provider who billed for evaluation & management (E&M) claims when the only service rendered was the administration of the COVID-19 vaccine. The E&M claims were not supported by the medical record. The provider was ordered to pay more than $86,000 to resolve their civil liability. In addition, cost avoidance in 2022 totaled $31,122, while savings to beneficiaries and others totaled $74,459 for all SMP projects.