Helping to ID Medicare fraud

Oakland, CA(Zone 9b)

A Benefits Statement You Can Read
NY Times May 9, 2012

(excerpt) There’s good news for anyone who has ever tried to decipher one of the currently inscrutable benefit statements, called Medicare summary notices, mailed quarterly to roughly 36 million beneficiaries. Starting next year, officials will begin using a new consumer-friendly format; it’s already available online at www.mymedicare.gov. The mysterious procedure codes are still there, but an easy-to-understand explanation of each service in larger type replaces the descriptions containing baffling abbreviations and medical terms.

The change comes with an incentive for reading more carefully: Medicare will offer rewards of up to $1,000 for tips that lead to uncovering fraud. Last year, Medicare recovered a record $4 billion in fraudulent payments with help from people who reported questionable charges.

Medicare officials are betting that beneficiaries and their caregivers can be even better fraud detectives if only they understand what they’re reading. “They are on the front lines, and they can identify problems at the source,” said Julie Bataille, a spokeswoman for Medicare.

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