Rhode Island Wins $229,000 to Prevent Medicare & Medicaid Fraud

Jun 17, 2015 Issues: Health Care, Social Security

Today U.S. Senators Jack Reed and Sheldon Whitehouse and Congressmen Jim Langevin and David Cicilline announced $229,489 in U.S. Department of Health and Human Services (HHS) funding for the Senior Medicare Patrol (SMP) project at the Rhode Island Division of Elderly Affairs (DEA). The funding will enable DEA to train SMP volunteers to educate Medicare and Medicaid recipients on how to detect and guard against fraud in the Medicare and Medicaid programs.

Medicare and Medicaid fraud schemes are often cloaked as “free” services for seniors, but come at a steep cost for taxpayers.  In testimony last year before the Senate Special Committee on Aging, the National Health Care Anti-Fraud Association estimated these losses cost approximately $60 billion annually.

According to HHS, national health care fraud recovery efforts — like SMP — led to the recovery of over $2.3 billion in fiscal year 2014, and every dollar spent on health care related fraud and abuse investigations earned a return of $8.10 in recoveries.

In Rhode Island over the past three years, Senior Medicare Patrol has conducted over 8,200 one-on-one counseling sessions for Medicare and Medicaid beneficiaries and caregivers, and trained over 7,700 people in group settings. Rhode Island SMP has also helped initiate investigations of 29 complex fraud issues.

“Medicare fraud is not a victimless crime because it costs U.S. taxpayers billions each year. This is a smart investment in helping Medicare recipients protect themselves from being victimized and empowering them to detect and report suspected fraud,” said Senator Jack Reed, who noted that Rhode Islanders wishing to report suspected Medicare fraud may call the RI Senior Medicare Patrol program at: (401) 462-0931 and all suspected fraud reports will be taken seriously.

“Medicare is a cornerstone of the safe and secure retirement our seniors deserve, and the Senior Medicare Patrol is helping to prevent the fraud and abuse that undermines it,” said Senator Sheldon Whitehouse. “Congratulations to Director Fogarty and the Division of Elderly Affairs on winning this grant, and thank you to all the Medicare Patrol volunteers for helping to protect our seniors.”

“After working full careers and contributing to our communities in so many ways, our seniors deserve to enjoy a fulfilling retirement. They’ve earned their health care and retirement benefits, and we must do everything we can to ensure those benefits are protected,” said Congressman Jim Langevin. “Older Americans are too often victimized by financial scammers and identity thieves, and the Senior Medicare Patrol is an important defense against the exploitation of seniors. This funding for the Senior Medicare Patrol Project will better protect Rhode Island seniors and empower them to recognize and fight health care fraud.”

“This funding will help ensure the Senior Medicare Patrol has the resources it needs to stamp out Medicare and Medicaid fraud in our state to make sure every dollar in these programs reaches the intended beneficiaries,” said Congressman David Cicilline. “I applaud the Rhode Island Division of Elderly Affairs on winning this funding, and I thank them for the work they are doing every day to protect Rhode Island seniors.”

“We have a responsibility to provide quality services and care for all of our neighbors, and that includes protecting our parents and grandparents against fraud and identity theft,” said Governor Gina M. Raimondo. “Thank you to our entire Congressional delegation for securing important funds to expand our Senior Medicare Patrol, strengthen retirement for seniors across our state, and ease the burden of fraud on taxpayers.”

“The support from our congressional delegation in pursuit of this funding allows the Division of Elderly Affairs to continue providing Senior Medicare Patrol services. The SMP volunteers and community partners deliver critical guidance and counseling to beneficiaries on the recognition and prevention of fraud. We are pleased to continue efforts to reach, educate, and assist greater numbers of Medicare and Medicaid beneficiaries in every Rhode Island community,” said Charles Fogarty, Director of the Rhode Island Division of Elderly Affairs.

SMP volunteers are made up largely of seniors and health and public safety professionals, such as doctors, nurses, law enforcement, and attorneys. Volunteers are trained on strategies to protect recipients’ identities, help recipients understand their Medicare Summary Notices, and avoid scams. SMP trainings can take place on a one-on-one basis or in presentations to groups.

DEA has operated the SMP project in Rhode Island since 2006. Rhode Island’s SMP project partners with numerous state and local entities, including the Office of Community Services and Catholic Charities, the Diocese of Providence, the United Way of Rhode Island, the Tri-Town Community Action Agency, East Bay Community Action, Inc., South County Community Action Inc., Westbay Community Action, Inc., and Child & Family Services of Newport County.

For more information on the Senior Medicare Patrol, visit: stopmedicarefraud.gov or smpresource.org.