CMS incentivizes patients to fight Medicare fraud

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The government is extending its anti-fraud campaign by making it easier for patients to detect fraudulent Medicare charges and letting them know about its reward in exchange for information. The Centers for Medicare & Medicaid Services on Saturday will release a new, user-friendly billing statement that encourages beneficiaries, especially seniors who are likely targets of fraud, to detect errors and false claims, CMS announced today.

The redesigned Medicare Summary Notice, to be available at mymedicare.gov this weekend, will have larger text and plain-English language rather than the usual 12-page document full of medical jargon and abbreviations, Kaiser Health News and The Washington Post reported.

The approach is simple. Offer a cleaner, more accessible format of the billing statement, and beneficiaries won't have to dig around.

"Consumer protection starts with making sure consumers not only get timely and accurate information, but that they understand what services they're receiving from Medicare," said Acting Administrator Marilyn Tavenner in the CMS announcement. "The new Medicare Summary Notice empowers Medicare's seniors and people with disabilities. The statement is easier to understand and navigate, and makes clear what information to check and how to report potential fraud. The new MSN also makes it easier for people with Medicare to understand their benefits and file appeals if a claim is denied."

The redesign reflects 18 months of research and suggestions from beneficiaries, CMS said. The increased attention to educating patients about fraud isn't all that surprising, considering the government's crackdown and, not to mention, financial recoveries from fraud activities.

Last year, Medicare saved taxpayers $4 billion, the largest amount ever reported in a single year, thanks to those who reported suspicious activity to Medicare, a fact advertised on the new form, KHN and the Post reported.

The Medicare Summary Notice also will include notification about the reward of up to $1,000 for a tip that leads to uncovering fraud--a little tidbit not found on current forms. Although the reward isn't new, the form now calls attention to it, providing an incentive for beneficiaries.

Most seniors aren't aware that there is a financial reward to uncovering fraud, the Miami Health Care Examiner reported. Eight months after 92-year old Floridian, Joe M, as the article called him, returned his rented wheelchair, the device company is still billing Medicare and getting paid for the fake claims. The new form will make the process and reward more visible.

In addition to the online form starting this week, paper copies of the Medicare Summary Notice will be mailed out quarterly to beneficiaries, starting in 2013.

For more information:
- read the Kaiser Health News and The Washington Post article
- here's the CMS announcement
- read the Miami Health Care Examiner article

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