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Senior Medicare Patrol Fights Fraud

Help prevent and identify scams


Bruce Voigts started receiving Medicare coverage in February, and although he's well versed in the system, he was nervous.

"It's a whole new insurance system," said Voigts, 65, of Branson West. "It's a change in the way I've been doing things for many years."

Voigts is hardly alone — nationwide, about 9,000 people become eligible for Medicare every day. More than 1 million Missourians are currently enrolled.

Unlike many of the new enrollees, Voigts knows what to look for when he receives his quarterly Medicare Summary Notice (MSN), the list of medical services for which Medicare has been billed. ­ Along with his wife, Phyllis, he is one of the more than 100 volunteers in the Missouri Senior Medicare Patrol, which helps people understand their MSNs — and helps prevent waste and identify fraud in the Medicare system.

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The Patrol is federally funded but operates through Care Connection for Aging Services in partnership with the Missouri Association of Area Agencies on Aging.

AARP Missouri has teamed up with Care Connection to offer seminars across the state to help educate Medicare beneficiaries.

The seminars go over how to enroll online at MyMedicare.gov, how to read MSNs and how to use resources such as the MSN "decoders" available on the AARP website. The seminars also encourage participants to become Senior Medicare Patrol volunteers.

Trained professionals

"AARP is very pleased to be a partner in this project because it's something very important when it comes to stopping waste," said Norma Collins, AARP Missouri associate state director for advocacy. "So many people are confused. Sometimes those statements … are intimidating."

Rona McNally, director of special projects for Care Connection for Aging Services in Warrensburg, said, "We train retired professionals to go out and educate within their communities — caregivers and providers — about the potential for Medicare scams, how to find them and report them." The volunteers tell people about the importance of reading their MSNs and asking:

  • Did you need that service?
  • Did you receive the service?
  • Did you see the provider?
  • Were you seen on the billing date?

Seniors who suspect something is amiss are encouraged to call the Patrol, which works with investigative agencies. "Seniors are the best frontline defense against fraud and abuse," McNally said. "They're going to know before anybody else."

She said the Patrol has helped launch 81 investigations that are now open; the results are hard to know for sure because investigative agencies often don't share detailed results.

The Patrol also counsels Medicare beneficiaries on ways to prevent fraud, such as refusing to give Medicare or Social Security numbers over the phone. Changes to Medicare are leading scammers to try to take advantage, she said. Unscrupulous salesmen may say they're with Medicare and try to sell an insurance policy that will replace Medicare.

"People think they are buying a supplement, but they are buying a replacement," McNally said. "We've spent a lot of time helping people straighten things out."

Voigts, the volunteer from Branson West, isn't shy about approaching strangers.

"I go out looking in churches, health clubs, retirement centers, care centers for the elderly," he said. "When I hear someone say, 'You know, I just don't understand this Medicare stuff' — to me, that's an open door. … I will step up to them and ask them if they would like some information that will help them understand it. Most of them do."

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He gives them a packet that includes a personal health care journal, where a patient can log questions for providers and track the services they receive.

"They want clarity … to take the fear out of the process," Voigts said. Medicare isn't all that complicated compared to other insurance plans, he said. "It's not drastically different but people don't understand that."

Phyllis Voigts said many people are appreciative.

"Just knowing someone has held out a hand can take some of the fear out of it," she said

For more information about the Senior Medicare Patrol or to find a seminar near you, call 1-888-515-6565 toll-free.

 

Tim Poor is a writer in Clayton, Mo.

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