DHSS Press Release |
Date: February 20, 2008 DHSS-19-2008 |
| Vincent P. Meconi, Secretary Jay Lynch, Communications Director (302) 255-9037, Pager (302) 247-8523 Email: jay.lynch@state.de.us |
PILOT PROGRAM LAUNCHED TO HELP REDUCE MEDICAID/MEDICARE FRAUD
New Castle, DE - Health care error, fraud, and abuse affect everyone. They contribute to the rising costs of health care and, in some instances, diminish the quality of care that is provided. Most health care providers are honest and are providing the best care that they can, but the small number who aren't find ways to steal billions of dollars from the health care system each year. Even more is lost to errors in billing that are never found. It is in our best interest, and the best interest of all citizens, to be informed, aware, and involved in stopping and preventing error or fraud.
To this end, the Division of Services for Aging and Adults with Physical Disabilitie Delaware Partners of Senior Medicare Patrol announces a Low Income Subsidy Rolling Counselor Pilot Project (LISRC Pilot Project) to help educate the culturally, educationally and economically diverse, hard to reach Medicare and Medicaid beneficiaries and their families; on how to recognize and protect themselves against Medicare and Medicaid Fraud and how to report fraud, waste and abuse. All individuals who contact the program, will be scheduled for an educational counseling session that involves application and submission assistance through the Social Security Administration.
This pilot project has defined three zip codes in New Castle County and Kent County, who have potentially high list of individuals who my be eligible. Delaware Partners of Senior Medicare Patrol, along with other partners, will start this outreach project on March 1, 2008 and run till May 31, 2008, with the following areas: New Castle (NCC) 19720: Elsmere (NCC) 19805: Wilmington (NCC) 19802
What to Look for:
Clients should be suspicious if a health care provider tells Clients that:
- The test is free; he only needs Clients Medicare number for his records.
- Medicare wants Clients to have the item or service.
- They know how to get Medicare to pay for it.
- The more tests they provide the cheaper they are.
- The equipment or service is free; it won't cost Clients anything. Be suspicious of providers that:
- Routinely waive co-payments without checking on Clients ability to pay.
- Advertise "free" consultations to Medicare beneficiaries.
- Claim they represent Medicare.
- Use pressure or scare tactics to sell Clients high priced medical services or diagnostic tests.
- Bill Medicare for services Clients do not recall receiving.
- Use telemarketing and door-to-door selling as marketing tools.
NEVER give Clients Medicare/Medicaid or Social Security number over the telephone or to people Clients don't know.
NEVER allow anyone to convince Clients to contact Clients physician requesting a service Clients don't need.
NEVER give Clients Medicare or Medicaid number to anyone for a free service. They don't need Clients Medicare or Medicaid number if the service is truly free.
NEVER accept medical supplies or equipment from a door-do-door salesperson. Neither the Federal Government nor Medicare sell supplies or equipment door-to-door.
NEVER believe anyone who says they are from Medicare or any Federal agency trying to sell Clients products or services. Neither the Federal Government nor Medicare endorses the products or services of any individual or company.
ALWAYS rely on Clients personal physician to recommend all medical services and equipment for Clients.
KEEP a record of Clients health care appointments and services.
READ Clients Medicare Summary Notice (MSN) carefully. Look for:
- Duplicate payments for the same service.
- Dates of service on the MSN that differs from the dates Clients actually received the service.
- Items or services Clients do not recall receiving.
- Billings for medical equipment or services that were not ordered by a physician.
CONTACT Clients health care provider, supplemental insurance company and/or carrier if Clients have questions about services listed on Clients MSN.
If Clients still have questions, CONTACT the Delaware Partners Senior Medicare Patrol Project at 800.223.9074
Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.
