In a recent episode of The Jeanne Parnell Show on WHCR 90.3 FM – The Voice of Harlem, Charles Clarkson, Program Director of the Senior Medicare Patrol (SMP)
of New Jersey, shed light on crucial aspects of identifying and reporting Medicare fraud, abuse, and errors. Medicare is the second-largest expenditure in the U.S. budget, following defense, so it’s essential to recognize the importance of identifying and reporting fraud.
Medicare abuse and waste is more widespread than anticipated. Charles noted, “Medicare estimates that by 2031, which is only 7 years from now, they may not have enough money to pay out 100 percent of the Medicare claims that are covered under Medicare rules. What would happen? Medicare will be more expensive.” This forewarning signals a potential rise in Medicare costs, urging proactive measures. SMP NJ educates and empowers beneficiaries to take on the job of understanding their plan type and coverage, staying informed of current scams such as unsolicited medical equipment deliveries and services, as well as reviewing medical statements or explanations of benefits, to avoid Medicare waste and abuse. He also notes that the most crucial aspect of Medicare prevention is reporting. Detecting and reporting instances of fraud contribute significantly to preserving the integrity and sustainability of the Medicare system.
Medicare fraud and abuse impacts everyone financially. Taxpayers experience diminishing Medicare funds for future coverage, while current beneficiaries may face increased costs to compensate for losses. To prevent Medicare fraud, Charles recommends that beneficiaries:
- Secure Their Medicare Card: Keep your Medicare card in a safe place and avoid carrying it at all times. Protect your Medicare number, sharing it only when necessary.
- Review Medical Statements: Examine Medical Summary Notices or Explanation of Benefits for discrepancies. Report any errors, abuse, or waste immediately.
- Question Medical Necessity: Ask whether specific tests and procedures are medically necessary. Avoid waste when possible.
- Stay Informed: Understand enrollment and plan change rules. Medicare coverage and rules may change each year. Seek assistance from State Health Insurance Assistance Program counselors, or visit org
- Explore Options: Use tools like Medicare Plan Finder to compare plans. Differentiate between Traditional Medicare and Medicare Advantage.
By staying informed and actively participating in Medicare protection, individuals can contribute to a more secure and resilient healthcare system for all. For more information, call 732-777-1940 or email [email protected] to schedule a free workshop for your group.
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JFS’ Senior Medicare Patrol (SMP NJ) program is part of a nationwide SMP network funded by the Administration for Community Living (ACL).
