Help prevent Medicare fraud, waste

Published 12:00 pm Thursday, March 31, 2016

Medicare waste, abuse and fraud cost American taxpayers anywhere from $60 billion to $100 billion a year and threaten the viability of the program.

At the low end of this estimate the average overpayment per beneficiary nationwide is over $1,100. While that is a staggering figure on a national level, do not think that this is a problem confined to other areas of the country. A recent report by the Council for Medicare Integrity places Mississippi as the third worst state for Medicare overpayments due to billing errors and abuse.

Additionally, the Zone Program Integrity Contractor, whose mission is to identify cases of suspected fraud, reports that health care fraud is rampant in Mississippi.

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In order to contain the rising cost of Medicare, it is incumbent upon all beneficiaries, their families and caregivers to become proactive in preventing this health care fraud and abuse. Fortunately there is help in the form of the Mississippi Senior Medicare Patrol, or SMP.

SMP is a federally-funded statewide program whose mission is to educate beneficiaries with a simple message. “Protect, Detect and Report.” Protect your Medicare benefits and the Medicare systems from dishonest health care providers by protecting your Medicare number. Do not give it out to people you don’t know. Don’t give it to anyone on the phone. Say “no” to offers of free medical equipment. Remember that your Medicare card number is more valuable than any credit card if the person who gets your number uses it to bill Medicare for services and products you have not received.

Detect possible fraud, waste or abuse by reading your Medicare Summary Notice or your Medicare Advantage Explanation of Benefits. These statements show all the claims that have been charged to your Medicare number. Look to see if the dates of the services make sense. Do you recognize the name of the health care provider? What is the location of the health care provider? If you see charges from some doctor you’ve never heard of, that could mean that your number has been stolen and someone is using it illegally.

Finally, report any suspicious activity. You could be uncovering a major scam or you might just have an innocent billing error. Either way, report it to Mississippi Senior Medicare Patrol at 877-272-8720.

The good news is that we are having an impact on health care fraud and abuse. SMP is a part of the larger Health Care Fraud and Abuse Control Program. Last year this program returned $2.4 billion in recovered funds to taxpayers. This represents over $6 returned for every $1 spent. To improve on these efforts, Mississippi SMP needs your help. For SMP to succeed in its mission it must have the help of volunteers.

SMP offers education sessions, community outreach events and one-on-one counseling. To learn more about the many services that SMP provides, visit

If your organization would like to schedule an educational event for your seniors or if you would like to become a volunteer and protect the ones who have protected us for so many years, call 877-272-8720.

Keith Havins is a community outreach specialist for Senior Medicare Patrol in Oxford and can be reached at