Friday, June 17, 2016

OIG Releases Senior Medicare Patrol Project Data

Dianne De La Mare 

The US Department of Health and Human Services, Office of Inspector General (OIG), has published a report, Performance Data for the Senior Medicare Patrol Projects, indicating that the Senior Medicare Patrol (SMP) is expecting $2.5 million in Medicare recoveries (attributable to its projects) for 2015. The vast majority of those recoveries resulted from one project’s efforts, which led to the conviction of a hospice company owner for Medicare fraud.

Overall, 2015 Medicare recoveries increased by 282 percent from $660,829 in 2014. In 2015, the SMP also reported a total of $35,059 savings to beneficiaries. This was a 56 percent decrease from $80,228 in 2014. The majority of those savings were the result of one project’s efforts involving four separate beneficiary complaints pertaining to one provider. The provider had charged the beneficiaries for monthly treatments when Medicare actually covered those treatments.

The SMP project helped the beneficiaries obtain refunds from the provider. Finally, the SMP projects reported a total of $21,533 in cost avoidance on behalf of Medicare and Medicaid beneficiaries. This is a substantial decrease of 89 percent from $200,598 in 2014.

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