Tuesday, August 27, 2013

CMS Educating Seniors on Healthcare Fraud

The Centers for Medicare and Medicaid Services (CMS) employs consumer education and engagement to fight identity theft and other healthcare related fraud against seniors.

The CMS's Senior Medicare Patrol (SMP) program recruits and trains retired professionals and other seniors about healthcare fraud prevention, identification, and reporting. These SMP volunteers educate their communities' Medicaid/Medicare beneficiaries, caregivers, and family members about fraud, as well as about billing errors and how to detect and report such instances.

"In 2010, more than $4 billion in fraudulent claims were returned to government agencies thanks to SMP activities." - Fraud Avengers, August 2013 Newsletter
Although SMP began in 1997, efforts have increased under the Affordable Care Act (ACA). The are now 5,600 volunteers nationwide and CMS is raising awareness with media outreach and consumer engagement programs.SMP volunteers also help to identify patterns of fraud and report those by working in close partnership with CMS and the federal Health and Human Services (HHS) Office of the Inspector General (OIG).

Healthcare organizations are also contributing to decreasing fraud by utilizing low-cost on-demand SaaS analytics to detect theft of medical identity data.

Download a white paper on patient privacy breach detection. Learn how to proactively identify unauthorized breaches of patient data privacy, even by authorized users - with no hardware and no on-site software.
Sources:
(a) Senior Healthcare Fraud - Protecting Fellow Seniors - FraudAvengers.org, August, 2013

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