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Despite intense opposition from provider groups, the U.S. Department of Health and Human Services (HHS) has recently announced 41 grants totaling $7 million to expand its so-called "senior patrol" program that recruits and trains retired professionals and other seniors to identify potential instances of fraud and abuse in the Medicare and Medicaid programs.
The new grants — 29 new and 12 renewed — will be distributed among 38 states, as well as Washington, DC, and Puerto Rico.
In turn, providers in these jurisdictions should expect to see an increase in questions from their Medicare patients in coming months regarding their treatment and billing procedures.
These Senior Medicare Patrol Project grants were created in 1997 by legislation sponsored by Sen. Tom Harkin (D-IA). Under the program, senior volunteers are trained to scrutinize their Medicare claim statements and question physician recommendations for possible questionable medical and billing practices. These unofficial fraud cops are then to report any suspected questionable charges or inappropriate services to the authorities.
The program already has trained some 6,000 retired volunteer instructors, who have, in turn, trained another 70,000 Medicare beneficiaries in ways to spot potential billing problems. Another 250,000 Medicare patient police are expected to be trained under these most recent grants.
While federal officials and other supporters like the American Association of Retired Persons argue the program simply aims to educate Medicare recipients about their rights, provider groups say it does more harm than good by creating suspicion between patients and their physicians while also generating a potential flood of well-intended but often unnecessary questions from patients, consuming extra time and money to answer.
New grants were allocated in Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Idaho, Indiana, Maine, Massachusetts, Michigan, Montana, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Puerto Rico, Texas, Utah, Virginia, and Washington.