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30 Month Performance Data for the HIPAA-Funded Projects

Health Care Anti-Fraud and Abuse Community Volunteer Projects

30 Month Performance Data for the HIPAA-Funded Projects
JULY, 1997 - DECEMBER, 1999

George Grob
Deputy Inspector General for Evaluation and Inspections
30-Month Performance Data for the HIPAA-Funded Projects (OEI-02-97-00525)

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

At the request of the Administration on Aging, we have continued to collect performance data for the 18 Health Insurance Portability and Accountability Act (HIPAA)-Funded Projects. The attachment presents cumulative performance data for the first 30 months of the projects. Please note that these data are self-reported and we have not verified their accuracy.

The HIPAA-Funded Projects have so far trained a total of 22,214 trainers. These trainers have gone on to educate a total of 45,287 beneficiaries, family members, caregivers, and others in their sessions. They have also educated 9,222 aging network staff and volunteers about health care fraud, waste, and abuse. An additional 482,683 people were reached through forums and other public information presentations. As a result of these efforts, the projects reported receiving 12,104 complaints, 7 percent of which resulted in some action.

The projects identified a total of $138,419 for Medicare recoupment. Of particular note, the New York project identified another $26.4 million to be recouped primarily in Medicaid funds. This was due to Medicaid/Medicare computer matches that identified double billings.

We will continue to monitor these projects and provide you with 36-month performance data.

Activity	AZ	CA	CO	FL	GA	IL	LA	MA	MO	NJ	NY	OH	OR	PA	TN	TX	VA	WA	TOTAL
A. Trainers
# of training sessions conducted for network agency staff, volunteers, and others	68	49	27	15	33	23	28	19	34	0	359	16	11	10	3	223	6	80	1,004
# of network agency staff, including volunteers, trained	910	1,254	46	264	1,137	787	255	469	1,426	0	3,525	916	539	352	95	2,828	145	421	15,369
# of other staff and volunteers trained	583	149	212	40	0	100	329	0	0	0	3,957	8	400	0	20	1,047	0	DK	6,845
Total # trainers trained	1,493	1,403	258	304	1,137	887	584	469	1,426	0	7,482	924	939	352	115	3,875	145	421	22,214
B. Public information
# of media events conducted	14	69	2	85	8	18	10	9	2	0	118	1	12	8	4	614	10	119	1,103
# of forums and other public information presentations conducted	135	56	27	117	5	21	16	8	14	20	492	56	2	15	91	619	111	482	2,287
# of persons attending these forums and other public information presentations	8,184	938	133,000	6,924	679	466	689	1,220	7,671	2,410	235,070	9,530	184	436	5,572	13,752	18,641	37,317	482,683
C. Trainer Activities
# of trainers currently promoting awareness and reporting of health care fraud and abuse	104	6	46	8	9	85	55	469	70	0	2,069	30	323	352	63	312	145	DK	4,146
# of education and training sessions conducted by trainers for network agency or for other staff and volunteers	134	25	311	2	9	11	21	80	0	0	0	DK	485	6	18	7	DK	DK	1,109
# of network agency and other staff and volunteers attending these sessions	472	606	460	11	286	604	351	2,780	0	0	0	DK	1,213	576	1,761	102	DK	DK	9,222
# of sessions conducted by trainers for beneficiaries, family members, care givers, and others	102	781	36	85	10	93	274	125	12	0	1,321	DK	1,130	46	0	64	DK	DK	4,079
# of beneficiaries, family members, care givers, and others attending these sessions	4,420	1,625	1,075	8,711	302	2,916	2,709	2,350	578	0	15,916	DK	1,695	1,975	0	1,015	DK	DK	45,287
Activity	AZ	CA	CO	FL	GA	IL	LA	MA	MO	NJ	NY	OH	OR	PA	TN	TX	VA	WA	TOTAL
D. Health care fraud and abuse complaint receipt and referral activity
# of complaints received attributable to the project	78	7,247	0	822	23	15	14	3,004	DK	32	157	32	15	DK	0	448	144	73	12,104
# of complaints referred for follow-up	41	5,440	0	18	17	15	11	2	DK	10	45	1	14	DK	0	100	110	13	5,837
# of complaints that resulted in some action	8	761	0	DK	DK	4	6	DK	DK	7	33	DK	9	DK	0	35	DK	3	866
Medicare $ recouped attributable to the project	115,000	DK	0	DK	DK	7,551	1,501	DK	DK	3,602	3,008	DK	DK	DK	0	6,357	DK	1,400	138,419
Other $ recouped attributable to the project	0	DK	0	DK	DK	0	0	DK	DK	0	26,400,000	DK	DK	DK	0	DK	DK	22,000	26,422,000
Total $ recouped attributable to the project	115,000	DK	0	DK	DK	7,551	1,501	DK	DK	3,602	26,403,008	DK	DK	DK	0	6,357	DK	23,400	26,560,419

Please note the following:

--Unlike previous reports, New York is included in the total.

--New York has always been a Senior Medicare Patrol Project grantee.

--The projects in AZ, OR, and VA are now also Senior Medicare Patrol Project grantees.

--The projects in LA, NJ, and OR were incorporated at a later date and are reporting 24-month data.