Boomers & Beyond: Preventing Medicare fraud

Listen up, my friends, to Ruth McCrea, Project Manager for the SHIP program located at the RSVP offices in Grand Junction.  

"Senior Health Insurance Assistance Project," explained McCrea.  "We help people with their Medicare issues."

We’ve all heard of Medicare fraud, but do we really know what it is exactly, how to spot it and how to protect us all? 

“Fraud is when you intentionally and knowingly try to commit fraud and defraud the Medicare trust,” said McCrea.

Fraud, scams and errors can be really costly…   

"It affects the tax payers because they end up paying more for services.  It damages the Medicare trust, the trust fund that keeps it going.  It takes advantage of the elderly and the people who are risk and then the people who are low income.  It takes money away from services that they might have been able to get if this money had not been stolen.”

Who all can be involved?

"It can be healthcare providers.  It can be people who work in a healthcare office.  It can be durable medical equipment suppliers and people who work for them. It can be the normal person who gets Medicare and they find a way that they can scam the system.”

And what kinds are there?

“Well, double-billing—sometimes things are double billed and people hope they won’t get caught, billing for services that were never provided, changing the diagnoses, like I said, to justify payment, ordering unnecessary lap tests, trying to prescribe durable medical equipment such as a wheelchair or scooter when the person doesn’t really need it," said McCrea.

Frauds and scams right here in our own back yard?  You better believe it!

“This last year, in February and March alone, there were three cases in Colorado that were settled and the people are now and jail and they are being told to pay restitution.  One was in Palisade.

What can we do and what is being done?

“The SMP wants people to protect, detect and report.  We’re the first line of defense.  We’re the grassroots people, down here where things are happening and if something doesn’t feel right in your gut, talk to us.”

So, exactly what is SMP?  Might you want to volunteer?

“The Senior Medicare Patrol.  And that’s people going out and sniffing out Medicare fraud.”

SHIP has many avenues of help and information like the Medicare 101 workshops.  Today, generations of families can be at the Medicare stage; watching out for each other is a must.  Let’s all heed Ruth’s advice.  We all need to be aware.  That means protect, detect and report and pick up your copy of the Medicare fraud tips sheet. 

Thanks to Ruth for alerting us.  For more information, contact Ruth McCrea – Volunteer/Ship Project Manager – 970-243-9839 or visit www.rsvpgrandjunction.org