Displaying items by tag: senior medicare patrol

The Nevada Senior Medicare Patrol (SMP) educates Nevadans on how to detect and report healthcare fraud in Medicare and Medicaid in order to protect these vital healthcare programs for the future.

Every year the Medicare system is drained of billions of dollars as a result of fraud, waste, errors and abuse - almost $134 MILLION in Nevada in 2008 alone!  The Nevada SMP is funded and supported by the U.S. Administration on Aging, and works closely with the Centers for Medicare and Medicaid Services.  There is an SMP in every state whose mission is to educate Medicare beneficiaries and their caretakers to become critical health care consumers, enabling them to identify suspicious situations or billings so that we can increase the chance that the Medicare system is solvent for future generations.

Examples of Abuse can include, but are not limited to:

• Billing for services different than actually provided
• Providing and billing for unneccessary procedures or services
• Overcharging for services
• Billing for a service or procedure provided by an assistant at a level that by regulation may only be charged by a doctor
• Billing for a higher level of service than what was actually provided (i.e. billing the level allowed for a new patient when actually the beneficiary is an existing patient)

Examples of Fraud can include, but are not limited to:

• Billing for services not received
• Billing non-covered services as covered services (i.e. billing routine nail care as foot surgery)
• Offers of "FREE" or medically unnecessary services and then billing Medicare

Medicare beneficiaries play a vital role in detecting these instances of abuse and we rely on them to report the errors to the Medicare system.

Here are some ways to protect yourself and the system:

• Protect your Medicare number!  In the wrong hands, it is a license to steal.  Unless you need it for a doctor's visit, leave your Medicare card at home, in a safe place.
• Record your doctor's visits in a Personal Healthcare Journal, which is available from the Nevada SMP program.
• Carefully review your quarterly Medicare Summary Notice and/or your Explanation of Benefits (from another insurance company). Check the dates of service to make sure there are no duplicate billings for services received and verify that the billing is for a service that you did receive.
• Don't be influenced by advertising for services, medications, or products.  Educate yourself and make your own decisions.

We are responsible for helping citizens across our state to identify issues to protect themselves and their loved ones from being victimized. We do this in a number of ways.

• We deliver presentations for interested parties to educate them on the signs of fraud, waste and abuse.
• We also recruit senior professional volunteers from the community to help. These dedicated seniors work at healthcare fairs, one-on-one counseling sessions and by networking with the state's senior service provider system to get our message into the community.
• We provide resources and referrals to other senior support agencies and non-profits in the state.
• Finally, we maintain a statewide, TOLL-FREE hotline (888-838-7305) so that Nevada beneficiaries have a local resource to resolve and/or investigate these complicated issues.

The Nevada SMP is here to help you! Please call us if:

• You suspect fraud, errors, waste or abuse to Medicare
• You are a retired professional senior who would be interested in volunteering.
• You are a member of a senior group, law enforcement agency or other interested community group that would like a presentation.

Our statewide, toll-free number is 1-888-838-7305.  We can also be reached by email at sdshott@adsd.nv.gov

Contact:
Mary Matiya, SMP Project Officer
1820 E. Sahara Ave, Ste 205
Las Vegas NV 89104