CMS recruits seniors to become Medicare fraud watchdogs

The Centers for Medicare & Medicaid (CMS) is simplifying its paperwork to assist a new army of fraud watchers—the seniors themselves.

Soon, people with Medicare coverage will be receiving new Medicare Summary Notices in the mail. The redesigned form will provide beneficiaries with a claims history for providers and suppliers used in a three-month period. Armed with this information, seniors and caregivers will be able to review claims for accuracy and join in the fight against Medicare fraud.

“The new Medicare Summary Notice gives seniors and people with disabilities accurate information on the services they received in a simpler, clearer way,” said CMS Administrator Marilyn Tavenner in a release. Beneficiaries will be able to understand their benefits or file an appeal for a denied service or supply. In addition, the claims history on the Medicare Summary Notice will be easier to review, enabling the beneficiary to identify potential Medicare fraud claims.

More than $14.9 billion has been recovered in the past four years with record-setting recoveries posted in 2011 and 2012. This past April, CMS proposed an increase in rewards to those whose tips help to recover funds.

Related story: CMS sweetens the deal for fraud whistleblowers

Sandra Hoban

Sandra Hoban was on I Advance Senior Care / Long-Term Living’s editorial staff for 17 years. She is one of the country’s longest-serving senior care journalists. Before joining Long-Term Living, she was a member of the promotions department at Advanstar Communications. In addition to her editorial experience, Sandi has served past roles in print and broadcast advertising as a traffic and talent coordinator.