Senior Medicare Patrols fight fraud, assist beneficiaries

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Before the global pandemic, Lou Hoger, standing, Senior Health Insurance Information Program (SHIIP) representative at the DCH, introduced about a dozen people to the Iowa Insurance Division's new Senior Medicare Patrol program at a February Lunch and Learn event, hosted by the Dallas County Hospital Foundation. 

About a dozen people learned about the Iowa Insurance Division’s new Senior Medicare Patrol program at Friday’s free Lunch and Learn event, hosted by the Dallas County Hospital Foundation.

Lou Hoger, Senior Health Insurance Information Program (SHIIP) representative at the DCH, also serves as the local Senior Medicare Patrol (SMP) person. Hoger said the SMP empowers Medicare beneficiaries, their families and caregivers in detecting, preventing and reporting health care fraud, errors and abuse.

The U.S. General Accounting Office estimates that $1 of every $7 spent on Medicare is paid inappropriately due to errors, fraud and abuse. Up to $50 billion was lost to Medicare fraud nationwide in 2017.

“We work one-on-one with Iowa Medicare beneficiaries and their caregivers or family members to review billing information for suspected fraud or errors,” Hoger said. “If a healthcare billing error is involved, we provide one-on-one counseling to help correct the error. If we determine fraud or abuse is possible, SMP makes a referral to the appropriate state and federal agencies to investigate.”

Almost 2 million Americans are served nationally by the SMP program’s outreach, counseling and education efforts, Hoger said. He said Iowans are encouraged to visit the SMP website to learn about new Medicare insurance scams and discover tips and tools to prevent and report Medicare fraud. Iowans can also call 1-800-351-4664 to report Medicare fraud or to make an appointment with a SHIIP/SMP counselor.

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