Senior Medicare Patrol Had Significant Drop in Fraud Recoveries Last Year
The Senior Medicare Patrol (SMP) has been an initiative of the Centers for Medicare & Medicaid Services (CMS) since the late 1990s, initially as a pilot project, and now operates initiatives in every state and territory, staffed by more than 5,000 volunteers. Despite the fairly dramatic notion behind the SMP—enlisting Medicare enrollees to be on the lookout for and report what they believe might be fraud—it has had modest results in recent years, according to a new report from the Office of the Inspector General for the U.S. Department of Health and Human Services. In calendar 2014, recoveries from Medicare and Medicaid fraud inquiries led to expected recoveries of ill-gotten payments totaling $661,333—a 93 percent decrease from 2013. But in 2013, much of the $9.1 million of expected recoveries were tied to what the agency called “a single event.” The OIG also noted that “we continue to emphasize that 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. In addition, the projects are unable to track the […]
Takeaway: The Senior Medicare Patrol has had significant but uneven success over the years in leading to recoveries from Medicare and Medicaid fraud.
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