A New Jersey group wants more seniors to step up to help cut down on Medicare waste and fraud. But many patients don’t want to drop a dime on their doctor.
While the government is devoting more resources to fraud prevention, experts say patients are the real “boots on the ground” when it comes to catching Medicare cheats.
Charles Clarkson, who coordinates New Jersey’s Senior Medicare Patrol Program, said many people are reluctant to speak up.
“If you’ve been going to a doctor for 20 years because you have a heart condition, are you going to want to report that doctor?” said Clarkson. “My answer to that is, if your doctor is cheating Medicare how do you know you aren’t being cheated?”
Clarkson wants more people to actually open their Medicare statement and report irregularities.
Lew Pinsker, a volunteer for Jewish Family and Vocational Service of Middlesex County, recalls an incident several years ago when his father was being treated at home by a podiatrist.
The visit was a routine foot exam, but Pinsker said the doctor submitted a $600 MRI charge — and the government paid the bill. Pinsker’s father tried to alert Medicare.
“As an elderly man, he was probably about 88 at the time, and also hearing impaired. He had a lot of difficulty dealing with the phone messaging system, the voicemail, and frankly he just hung up the phone and never followed up on it,” Pinsker said.
Jewish Family and Vocational Service helps seniors navigate the Medicare system.
One tip, Clarkson says, is to keep a health-care journal.
“Every time they go to a doctor, they should write it down. Every time they take a test, they should write it down,” he said. “The idea is to compare the calendar with the statements.”
In Pennsylvania, the Center for Advocacy for the Rights and Interests of the Elderly runs the state’s Senior Medicare Patrol Program to help prevent fraud.
Clarkson said about $1 in every $10 spent on U.S. public insurance programs is lost to fraud, waste and abuse.