Seniors Saving Medicare

Silver Tips is written by the Senior Citizens’ Law Office in Albuquerque.

Seniors across New Mexico are doing their part to protect the funds that cover their healthcare costs.

They volunteer with Seniors Saving Medicare, a program of the New Mexico Aging and Long-Term Services Department aimed at reducing the amount of Medicare dollars lost through waste, fraud and abuse.

The volunteers educate the public about identifying Medicare and Medicaid fraud and waste in bills from hospitals, doctors and other health care providers.

The volunteers also take calls on a toll-free hotline from patients who believe they may have been used by a health provider to falsely claim Medicare or Medicaid payments.

Seniors Saving Medicare is part of an initiative by the federal Health and Human Services Department. Since its inception in 1997, $51 million has been returned to the federal government, according to an estimate by the HHS Inspector General.

Health care providers intent on cheating Medicare have some common methods. You should be suspicious of the providers if they:

• Encourage you to buy medical equipment, services or tests that you don’t need;

• Advertise "free" consultations to Medicare beneficiaries or offer tests, equipment

• or service for free, but tell you they’ll need your Medicare number for their records. (If it’s a free offer, they won’t need your Medicare number);

• Tell you that Medicare wants you to have the item or service. (Medicare doesn’t prescribe services or treatments);

• Say they know how to get Medicare to pay for a service or treatment. (This suggests the person is going to cheat Medicare. Don’t let them do it);

• Tell you the more tests they provide, the cheaper they are. (Rates of payment are not determined by the number of services or tests.)

• Routinely waive co-payments without checking on your ability to pay (The copayment could end up being folded into the amount you have to pay after Medicare pays its share); and

• Claim they represent Medicare (Medicare does not have representatives in the healthcare business).

To arrange a speaker or if you have questions about Medicare and Medicaid fraud, waste or abuse, call the Aging and Long-Term Services Department toll-free at 866-451-2901.