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CEJC is partnering with California Health Advocates’ (CHA) Senior Medicare Patrol (SMP) to spread the word about how Medicare fraud harms beneficiaries, their caregivers, and the public. SMP recruits and train volunteers to raise awareness about Medicare fraud and to work one-on-one with beneficiaries to investigate and resolve complaints. California’s SMP is one of 54 programs across the country that are supported by the Administration for Community Living and is operated by the non-profit California Health Advocates (CHA), which brings additional expertise and resources to the partnership. CHA is the leading voice for Health Insurance Counseling and Advocacy Programs (HICAP) in the state. HICAPS also engage volunteers to provide counseling, education, and individual assistance on health benefits and long-term care.
New! (September 2, 2020) HICAP Flyer Available
In these challenging times of COVID, fires, smoke and heat, Senior Medicare Patrol (SMP) wants older adults and persons living with disabilities to know that the HICAPs are providing free, unbiased information about Medicare during the annual open enrollment season. SMP has produced informational flyers in English and Spanish:
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CHA-SMP collaborates with advocacy organizations across the state and nation to address the adverse impacts of the social determinants of health, including lack of healthcare and education, isolation, and poverty. Together, CHA-SMP partners serve persons with disabilities and older adults, their families, and caregivers. They raise awareness, increase safety and security, and provide resources that enhance lives. For more on the partners, see Partners. |
- The new partnership could not have come at a better time, when the COVID-19 pandemic has unleashed a barrage of scams that target older adults. These range from fake treatments, to extortionist prices for protective gear, to the theft of personal information. The turbulent market has panicked many investors, raising their risk for investment fraud as they try to secure their assets. The staggering number of COVID-19 related deaths in nursing homes is raising questions about facilities’ infection control procedures and monitoring.
- Lisa Nerenberg, Executive Director, CEJC
What is Medicare Fraud?
Medicare fraud ranges from health care providers who submit bills for services they have not provided to criminal neglect and abuse by nursing homes that receive Medicare funding. The harm to beneficiaries can be devastating. A study by Johns Hopkins showed that Medicare patients who were treated by clinicians who were later banned from the program for fraud were as much as 17% more likely to die prematurely than patients treated by non-banned clinicians. In 2013, fraud and abuse contributed to 6,700 premature deaths, the researchers concluded.
CEJC is working with CHA-SMP to prevent scams and financial abuse and to achieve equity in access to services and benefits.
Preventing Scams and Financial Abuse |
Equity in Access to Services |
CEJC is working with CHA-SMP to help Medicare beneficiaries access health benefits and resources, avoid and report fraud, and exercise their rights as consumers by:
Resources for Preventing Scams & Financial AbuseSadly, criminals are taking advantage of the COVID-19 pandemic to defraud and exploit older and vulnerable adults. The following resources provide comprehensive, up-to-date information to combat this insidious form of crime.
COVID-19 Fraud. SMP's website describes what consumers can do to prevent COVID-19 related fraud and Medicare-covered services related to the virus. Baker Fraud Report. The Baker Fraud Report focuses on mass marketing fraud – where victims never meet the fraudster in person but communicate over the phone, though the mail, or on the internet. Avoid Coronavirus Scams: What You Need to Know. This comprehensive guide to Coronavirus themed scams produced by the pro-consumer website Comparite. It displays things to look out for and ways people can protect themselves. Just as elders of color and the poor are at heightened risk for infection and death, they are also being targeted for fraud. The following culturally specific, in-language resources were designed to improve access to help and information:
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Together, CEJC and CHA-SMP are improving access to services and benefits by underserved communities by:
Resources for Achieving EquityNational Center for Equitable Care for Elders (NCECE)
This program of the Harvard School of Dental Medicine was created to improve the health and wellbeing of older adults by increasing the number of older adult patients effectively served by health centers, decreasing the percentage of older adult patients with uncontrolled type II diabetes, and increasing the number of health centers providing services or engaged in partnerships that address social determinants of health, such as housing security, level of education, employment, access to transportation, and food security. Addressing Undocumented Immigrants' Health Care Needs Through Safety Net Systems in California This February 21, 2018 seminar presents data from a California Health Interview Survey and stakeholder interviews that were conducted by Paul Dourgnon, Faculty Associate at the UCLA Center of Health Policy Research. It explores how well immigrants are served by California’s safety net and the health outcomes are for immigrants who are able to access services. Senior Bleak Streets Series In this two-part English/Spanish series in La Opinión, reporter Agustin Durán describes challenges faced by the near-poor and undocumented Latino seniors in accessing health care.
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