There was a topic mentioned in President Obama's speech to the nation and Congress on Feb. 24 that is exactly what the ND SMP program is working on! "In this budget . . . we will root out the waste, fraud and abuse in our Medicare program that doesn't make our seniors any healthier . . ." Those three words waste, fraud and abuse are part of SMP's motto: working to protect the Medicare trust funds and to protect Medicare beneficiaries from the negative effects of money lost due to fraud and errors in Medicare payments.
This is not a Democratic or Republican issue. Medicare provides health insurance to 95 percent of America's population aged 65 and over. Medicare spent over $430 billion in 2007 and health care spending is projected to grow by 5 to 6 percent each year for several years into the future.
If you are a Medicare beneficiary, or a caregiver to someone who is, or if you are now working or worked in the past and paid Social Security/Medicare taxes, you are affected by Medicare fraud and payment errors!
Doesn't one of those descriptions fit almost every person?
This is not a problem just for Congress and the president to solve. You can take a bite out of crime! You can find Medicare payment mistakes or report suspicious charges. By talking to your medical provider, you can ask questions and report problems regarding payments made on your behalf by Medicare. What if you have difficulty doing that? You are not alone. The U.S. Department of Health and Human Services Office of Inspector General (which investigates Medicare and Medicaid fraud) plans to study how well people understand the Medicare Summary Notice (MSN); even the government itself recognizes how hard it is to interpret the information on the notices!
It's no news that life is challenging but that doesn't have to stop us. You can be Medicare "detectives." This means you shouldn't throw away those Medicare Summary Notices when they arrive in the mail every three months. Take a look to see if the dates of medical visits match up with your calendar, look at the description of the medical service to see if that's what you had done, look at the amount to see if it's about what you expected. If it's difficult to understand your notice, ask a family member or your caregiver to look at it with you, or take it with you the next time you go to the medical office that submitted the charges on that Medicare Summary Notice. If you believe Medicare has made an incorrect payment or you think Medicare paid for charges that weren't yours but you can't get it resolved with the medical provider, call 1-800-233-1737 for assistance. You can help save Medicare funds and reduce the possibility that benefits will be reduced in the future or that premiums skyrocket. There are 43 million Americans on Medicare; if every person found just one $10 mistake, we could save $430 million! That wouldn't be "government" saving some money, that would be YOU saving Medicare!
Note: This article was reprinted with permission from the National Consumer Protection Technical Resource Center
Linda Madsen is project director for N.D. Center for Persons with Disabilities in Minot.