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Three Year and One Year Performance Data for the Senior Medicare Patrol Projects

Activity	TOTAL	CA	HI	IA	IL	MD	MN	MO	NH	NY	PA	RI	WI
Three Year Outcomes Reported by The Senior Medicare Patrol Projects
See Also: Cover Memorandum Summarizing the data Definitions
OUTPUTS
# training sessions	726	55	16	22	19	57	52	12	7	389	41	9	47
# trainers trained	11,945	734	129	859	235	855	332	49	303	7,620	76	228	525
# media events	2,325	147	67	366	74	137	293	49	735	167	41	113	136
# community education events	2,255	0	42	85	110	513	301	100	113	594	264	30	103
OUTCOMES
total # trainers who have ever conducted activities	3,245	236	45	DK	235	16	92	49	20	2,362	50	23	117
# group sessions	4,439	802	126	439	1,070	35	348	84	318	466	343	193	215
# beneficiaries at group sessions	183,529	41,108	5,512	16,174	39,668	5,200	7,543	3,501	5,724	19,894	28,590	4,101	6,514
# one-on-one sessions	14,245	564	0	112	422	2,799	350	1,130	6,006	2,384	375	DK	103
total # beneficiaries educated	197,774	41,672	5512	16,286	40,090	7,999	7,893	4,631	11,730	22,278	28,965	4,101	6,617
estimated # people reached by media events	33,356,284	4,876,510	271,183	1,000,000	10,424,000	195,000	195,648	140,000	950,000	663,108	2,030,000	7,548,300	5,062,535
estimated # people reached by community education events	8,496,421	0	2,578	11,646	6,675	33,725	13,411	140,000	15,003	239,436	8,005,000	13,593	15,354
# complaints received	7,611	564	19	725	195	625	185	17	4,688	183	310	28	72
# complaints referred for follow-up	1,033	146	3	298	73	137	106	15	41	56	88	27	43
# complaints resulting in some action	266	27	0	22	DK	98	26	DK	14	37	24	DK	18
Medicare $ recouped	1,522,725	113,722	0	1,145,767 *	DK	DK	109,997 *	DK	0	3,008	144,164	DK	6,067 *
Other $ recouped	626,923	34,000	0	58,691	146,485	DK	15,805	177,724	180,075	0	DK	DK	14,143
Total $ recouped	2,149,648	147,722	0	1,204,458	146,485	DK	125,802	177,724	180,075	3,008	144,164	DK	20,210

Please note the following:
--New York is also a HIPAA-funded Project grantee.
* Pending documentation of actual recoupments

Activity	TOTAL	AK	AL	AR	AZ	CO	CT	DC1	DC2	DE	FL	GA3	GA4	ID	IN
One Year Outcome Reported by New Senior Medicare Patrol Projects
OUTPUTS
# training sessions	288	38	7	1	6	14	1	7	0	4	3	4	8	9	0
# trainers trained	2,463	42	101	12	8	131	6	29	0	36	31	40	102	23	0
# media events	1,264	28	11	2	3	11	14	7	0	791	23	0	2	2	0
# community education events	1,020	33	24	46	42	18	0	13	14	26	38	1	29	28	0
OUTCOMES
total # trainers who have ever conducted activities	504	35	18	2	8	16	6	7	0	16	7	40	33	13	0
# group sessions	1,225	5	12	5	21	152	32	18	0	33	4	32	87	37	0
# beneficiaries at group sessions	54,111	141	625	185	5,981	5,618	2,500	639	0	769	51	1,371	2,971	647	0
# one-on-one sessions	11,028	996	89	DK	4	52	0	8	0	2	77	0	2	31	0
total # beneficiaries educated	65,139	1,137	714	185	5,985	5,670	2,500	647	0	771	128	1,371	2,973	678	0
estimated # people reached by media events	11,776,346	80,000	100,450	40,000	22,000	420,098	161,500	55,000	0	106,988	1,262,589	0	20,000	450	0
estimated # people reached by community education events	90,646	1,500	1,920	2,950	8,655	2,220	0	2,275	412	3,552	7,398	60	3,002	1,122	0
# complaints received	1,334	321	22	1	281	21	10	30	0	36	14	0	0	114	0
# complaints referred for follow-up	448	2	17	1	15	5	10	7	0	2	7	0	0	76	0
# complaints resulting in some action	195	0	2	0	DK	DK	0	0	0	0	1	0	0	28	0
Medicare $ recouped	85,225	0	0	0	DK	DK	0	0	0	0	0	0	0	10,970 *	0
Other $ recouped	25,170	9,887	0	0	DK	DK	0	0	0	0	0	0	0	0	0
Total $ recouped	110,395	9,887	0	0	DK	DK	0	0	0	0	0	0	0	10,970	0

Please note the following:
The new Senior Medicare Patrol Projects in AZ, OR, and VA are also HIPAA-funded Project grantees.
Please note these distinctions:

1. The AARP Foundation, DC 2. Friendship House, DC 3. Atlanta Regional Commission, GA 4. Department of Human Resources, GA

* Pending documentation of actual recoupments

Activity	MA	ME	M I	MT	NM	NV	OH	OK	OR	PR	TX5	TX6	UT	VA	WA
One Year Outcome Reported by New Senior Medicare Patrol Projects
OUTPUTS
ing sessions	18	10	17	2	2	23	2	1	11	6	6	12	5	11	60
# trainers trained	108	59	231	15	50	30	63	12	61	50	102	36	39	208	838
# media events	101	19	3	11	19	20	37	2	26	12	4	20	3	76	17
# community education events	43	48	2	34	31	15	43	25	10	300	12	57	8	78	2
OUTCOMES
total # trainers who have ever conducted activities	24	11	18	0	9	8	41	3	27	3	20	22	5	73	39
# group sessions	73	8	43	0	7	13	84	1	28	0	7	50	15	195	263
# beneficiaries at group sessions	2,194	481	2,873	0	210	450	3,062	1,168	538	0	510	1,163	350	5,540	14,074
# one-on-one sessions	1,283	8	0	0	23	12	196	0	21	5	0	137	42	0	8,040
total # beneficiaries educated	3,477	489	2,873	0	233	462	3,258	1,168	559	5	510	1,300	392	5,540	22,114
estimated # people reached by media events	137,000	546,700	1,100	22,760	168,000	3,110,332	1,004,987	20,100	1,406,250	650,000	500,000	1,025,000	1,700	901,932	11,410
estimated # people reached by community education events	370	3,511	150	849	9,312	1,370	4,990	2,077	5,294	4,000	1,500	2,336	2,400	17,271	150
# complaints received	5	11	105	0	24	38	6	0	1	150	0	35	0	90	19
# complaints referred for follow-up	1	7	41	0	7	7	1	0	1	150	0	8	0	71	12
# complaints resulting in some action	DK	0	DK	0	7	2	0	0	1	140	0	2	0	DK	12
Medicare $ recouped	DK	0	17,269 *	0	4,927 *	787 *	0	0	DK	DK	0	0	0	DK	51,272 *
Other $ recouped	8,626	0	2,466	0	382	3,723	0	0	DK	DK	0	86	0	DK	0
Total $ recouped	8,626	0	19,735	0	5,309	4,510	0	0	DK	DK	0	86	0	DK	51,272

Cover Memorandum

From:     George Grob
               Deputy Inspector General
               for Evaluation and Inspections

Subject: Three Year and One Year Performance Data for the Senior Medicare Patrol Projects (OEI-02-97-00527)

To:          Edwin Walker, Director
               Office of Program Operations and Development
               Administration on Aging

At the request of the Administration on Aging (AoA), we have continued to collect performance data from the 12 original Senior Medicare Patrol Projects and the 29 new Senior Medicare Patrol Projects. Attachment A presents performance data for the entire three years of the original projects. Attachment B presents performance data for the first year of the new projects. Please note these data are self-reported and we have not verified their accuracy.

Having just finished their three year grant period, the original 12 Senior Medicare Patrol Projects have accomplished much in training and educating beneficiaries about fraud, waste, and abuse. They trained close to 12,000 trainers who later went on to educate about 198,000 beneficiaries. They also reached an estimated 42 million through community education events and the media. These beneficiaries are trained to scrutinize their Medicare bills and summary notices and to report potential errors to their medical care providers, Medicare insurance contractors, or the Office of Inspector General (OIG) fraud hotline.

In addition, these projects received 7,600 complaints through one-on-one counseling with beneficiaries and through their own local hotlines. Of the complaints that were investigated, the projects helped identify a total of $1.5 million in Medicare funds for recoupment. However, projects were able to provide documentation of actual recoupment for only $261,000. It is important to note that the projects continue to have difficulty tracking such recoupments.

As for the 29 new Senior Medicare Patrol Projects, they have made significant progress in the past six months. The total number of trainers they have trained has more than doubled in the past 6 months, from 934 to 2,463. The total number of beneficiaries educated by these trainers has tripled, from 22,267 to 65,139. The complaints the projects have received and the money identified for recoupment have also shown large increases. Currently, the projects have received 1,334 complaints and have identified $85,000 in Medicare funds for recoupment. However, projects have not been able to provide documentation of any actual recoupments.

As a whole, the Senior Medicare Patrol Projects have trained 14,408 trainers and educated 262,913 Medicare beneficiaries through sessions. It should be noted that the most substantial savings which are expected to arise from projects under both of the above programs will be derived from a sentinel effect whereby fraud and error are reduced in light of Medicare beneficiaries' scrutiny of their bills. Savings will also result from reports of fraud and error made to the Medicare contractors and to the OIG fraud hotline. It is not feasible, however, to track these effects entirely.

We will continue to monitor the projects and provide you with 40-month and 18-month performance data. If you have any questions, please call me at (202) 619-0480 or have your staff call Jack Molnar at (212) 264-1998.

Definitions
RETIRED PROFESSIONAL	These are retired individuals who were professionals (e.g., teachers, lawyers, doctors, or accountants), who are new volunteers to the aging network, and who are trained to help beneficiaries identify Medicare fraud.
OTHERS	These are any other individuals who are trained to help beneficiaries identify Medicare fraud.
RECRUITING	Any effort to get individuals to take the training to become a trainer.
TRAINING	The process of training the trainer.
SUPPORT	Any activity to help the trainers, such as transportation, renting space, printing material, and telecommunications.
TRAINED	Completed training to conduct beneficiary education.
MEDIA EVENTS	Any individual airing or publishing of media (e.g., print, radio, television, or electronic) to educate beneficiaries and their families about Medicare fraud. (If it is geared to trainers it is recruiting.)
COMMUNITY EDUCATION ACTIVITIES	Any beneficiary education activity not given by trainers or counted as media events.
BENEFICIARIES	Includes beneficiaries, family members, caregivers, and others who attended sessions.
GROUP SESSIONS	Medicare fraud education sessions for beneficiaries, family members, caregivers, and others led by trainers.
ONE-ON-ONE SESSION	Sessions led by trainers for an individual beneficiary and/or his or her family.
COMPLAINTS	Allegations of health care fraud and abuse reported by any individual as a result of the projects efforts.
COMPLAINTS REFERRED FOR ACTION	Complaints deemed worthy of referring to a Medicare contractor or an investigative agency.
COMPLAINTS THAT RESULTED IN SOME ACTION	Referrals successfully closed by a Medicare contractor or an investigative agency (e.g., conviction, judgement, plea, or overpayment).
MEDICARE $ IDENTIFIED FOR RECOUPMENT	Funds where recoupment action has been initiated by a Medicare contractor or a law enforcement agency.

Please note the following:
The new Senior Medicare Patrol Projects in AZ, OR, and VA are also HIPAA-funded Project grantees.

Please note these distinctions:
5. Baylor University, TX 6. The National Hispanic Council on Aging, TX

*Pending documentation of actual recoupments

Cover Memorandum

Definitions