TO:  Edwin L. Walker 
Deputy Assistant Secretary for Policy and Programs 
Administration on Aging 
FROM:  Debra L. Robinson /S/ 
Acting Deputy Inspector General 
for Evaluation and Inspections 
SUBJECT:	 Performance Data for the Senior Medicare Patrol Projects: October 2003 
Performance Report (OEI-02-03-00121) 
At the request of the Administration on Aging (AoA), the Office of Inspector General (OIG) collects 
performance data for the Senior Medicare Patrol Projects. Twelve projects have been in operation 
since the inception in 1997. An additional 29 projects were added in 1999. Seven projects began 
operating in 2000. Four new projects were added in 2001, and four more in 2002. The attachments 
present cumulative performance data for each of the 56 projects. Three of the 56 projects -- Arkansas 
Seniors Organized for Progress, Texas-Baylor University, and Ohio-Western Reserve Area Agency on 
Aging -- ceased operations in 2002. We collected the data from each of the projects for the 6-month 
period, January through June 2003. Please note that we have not independently verified the accuracy of 
these self-reported data. 
From July 1, 1997, through June 30, 2003, a total of 39,735 volunteers have been trained to detect 
fraud, waste, and abuse in the Medicare program. In-turn, these volunteers have conducted 294,649 
training sessions and one-on-one encounters, in which approximately 1.37 million Medicare 
beneficiaries were educated.  Once educated, these beneficiaries reported 33,125 complaints, of which 
7,181 were referred for follow up. Investigative agencies took action on 3,204 of these referrals. In 
total, the projects are responsible for the recoupment of over $103 million to Medicare, Medicaid, and 
other payers.  Specifically, this total includes $3,751,894 in Medicare funds recouped.  The projects 
have also self-reported recoupment of $99,318,530 to Medicaid and other payers. 
The 53 projects that are currently operating trained a total of 5,035 new volunteers from January 
through June 2003. As a result of holding 94,154 training sessions and one-on-one encounters, 
volunteers educated 273,559 Medicare beneficiaries during these 6 months.  Almost 10,000 complaints 
were reported to the projects between January and June 2003. Documentation received provides 
evidence of $72,249 in Medicare funds recouped in the 6-month period as a direct result of the 
projects. Self-reported savings to other payers totaled $21,871,947.  Page 2  Edwin L. Walker 
Of the 53 current projects, 11 reported savings to the Medicare program in the past 6 months. Six of 
these projects submitted Centers for Medicare & Medicaid Servicess contractor-based complaint 
tracking system reports. These reports, forwarded from the Medicare contractors to the projects, 
provide clear documentation of savings to the Medicare program.  Of the money that was reported 
recouped in the past 6 months, $58,287 was documented in these tracking reports. 
We continue to emphasize that a significant number of the beneficiaries, who have learned to detect 
fraud, waste, and abuse from the Senior Medicare Patrol Projects, are calling the OIG fraud hotline or 
other contacts.  The projects are not able to track this activity, and thereby, are not receiving full credit 
for savings attributable to their work.  In addition, substantial savings, which cannot be tracked, may be 
derived from a sentinel effect whereby fraud and errors are reduced in light of Medicare beneficiaries 
scrutiny of their bills. 
We will continue to monitor the projects and provide you with summary reports of performance data. If 
you have any questions, please call me at (202) 619-0480, or one of your staff may contact Thomas 
Zimmermann at (212) 264-2000. 
Attachments  APPENDIX A 
72-Month Outcomes Reported by the 12 Senior Medicare Patrol Projects beginning July 1, 1997 
Activity  TOTAL  CA  HI  IA  IL  MD  MN  MO  NH  NY  PA  RI  WI 
OUTPUTS 
# training sessions  1,742  103  65  338  32  268  98  42  20  592  86  13  85 
# trainers trained  22,933  2,273  308  2,775  286  2,917  610  212  734  11,254  335  253  976 
# media events  31,014  225  4,698  2,775  6,120  396  454  74  1,106  424  80  8,998  5,664 
# community education events  6,487  148  76  906  378  1,593  936  265  268  1,234  349  86  248 
OUTCOMES 
total # trainers who have ever 
conducted activities  6,952  412  151  DK  259  110  307  212  711  4,357  172  26  235 
# group sessions  11,629  1,848  386  1,960  1,751  1,264  907  272  477  1,202  790  295  477 
# beneficiaries at group sessions  508,926  84,848  12,469  61,514  74,763  30,346  16,593  14,021  64,243  34,428  94,030  7,135  14,536 
# one -on-one sessions  68,060  713  0  292  591  12,698  589  17,410  24,563  10,483  375  1  345 
total # beneficiaries educated  576,986  85,561  12,469  61,806  75,354  43,044  17,182  31,431  88,806  44,911  94,405  7,136  14,881 
estimated # people reached by 
community education events  9,418,181  59,936  30,064  336,282  37,731  89,206  29,113  249,652  65,373  376,927 8,016,179  90,623  37,095 
# complaints received  17,241  831  239  1,246  368  1,625  354  46  4,797  6,221  1,185  60  269 
# complaints referred for 
follow up  1,933  275  53  424  117  243  157  44  119  239  107  40  115 
# complaints resulting in some 
action  693  65  DK  46  12  104  69  14  43  239  41  6  54 
Medicare $ recouped  $2,812,254  $1,334,952  DK  $1,147,524  $0  DK  $109,997  $10,910  $107  $52,699  $144,339  $0  $11,726 
Other $ recouped  $97,971,501  $75,596  DK  $1,324,867  $146,485  DK  $31,681 $2,124,926  $150,052  $94,101,2001  $1,935  $0  $14,759 
Total $ recoupe d  $100,783,755  $1,410,548  $0  $2,472,391  $146,485  $0  $141,678 $2,135,836  $150,159  $94,153,899  $146,274  $0  $26,485 
Note: DK = Do not know 
1  Represents recoupments to the Medicaid program due to adjustments to Medicaid claims for individuals who are also entitled to Medicare.   
 
    APPENDIX B 
 
48-Month Outcomes Reported by the 29 Senior Medicare Patrol Projects beginning July 1, 1999
 
 
 
                               
Activity  TOTAL  AK  AL  AR2  AZ  CO  CT  DC3  DC4  DE  FL  GA5  GA6  ID  IN 
   
                           
 
OUTPUTS                        
 
     
# training sessions
3,188  63  103  12  75  42  32  13  9  55  38  63  325  240  18
 
     
# trainers trained
13,132  130  391  129  198  334  524  63  70  388  302  170  2,225  850  332
 
   
# media events 
23,865  51  126  35  551  49  903  37  55  4,770  996  71  1,148  3,952  56
 
     
# community education events 11,516  82  367  91  435  648  796  50  29  144  214  75  2,389  254  160
                                              
OUTCOMES 
     
total # trainers who have ever 
   
conducted activities 
5,720  83  352  43  168  44  383  63  28  99  137  155  946  204  25
     
# group sessions 
13,716  102  471  92  410  432  123  227  96  439  268  521  2,840  884  62
     
# beneficiaries at group 
   
sessions 
531,032  3,354  23,622  8,787  56,751  12,206  4,012  7,222  3,061  11,112  15,333  14,753  85,488  46,806  1,767
     
# one-on-one sessions 
185,257  2,391  503  51  280  265  71  130  670  84  461  1,238  3,284  1,175  104
 
total # beneficiaries educated  716,289  5,745  24,125  8,838  57,031  12,471  4,083  7,352  3,731  11,196  15,794  15,991  88,772  47,981  1,871
     
estimated # people reached by 
   
community education events 
3,023,338  37,201  71,726  9,673  67,977  23,388  43,169  187,650  21,000  135,791  183,681  5,745 1,120,680  14,876  26,533
     
# complaints received 
14,749  448  277  50  2,035  229  194  402  94  147  607  74  43  6,225  8
     
# complaints referred for 
   
follow-up 
4,944  22  138  14  152  19  35  55  0  31  23  12  21  2,790  8
     
# complaints resulting in some 
   
action 
2,371  7  23  DK  22  DK  4  11  0  1  9  0  5  1,425  2
     
Medicare $ recouped 
$249,879  $0  $0  DK  $429  $453  $30,785  $1,329  $0  $5,388  $4,601  $0  $0  $10,970  $4,441
     
Other $ recouped 
$1,326,679  $13,495  $0  DK  $3,271  $3,450  $0  $0  $0  $0  $121,359  $0  $0  $687,037  $0
   
Total $ recouped 
$1,575,328  $13,495  $0  $0  $3,700  $3,903  $30,785  $1,329  $0  $5,388  $125,960  $0  $0  $698,007  $4,441
 
2.  Project ended June 30, 2002         3.  The AARP Foundation, DC        4.  Friendship House, DC          5.  Atlanta Regional Commission, GA         6.  Department of Human Resources, GA      
 
   
 
                       APPENDIX B 
 
48-Month Outcomes Reported by the 29 Senior Medicare Patrol Projects beginning July 1, 1999 
 
 
 
                               
Activity  MA  ME  M I  MT  NM  NV  OH7  OK  OR  PR  TX8  TX9  UT  VA  WA 
   
                           
 
OUTPUTS                      
 
 
# training sessions 243  110  45  32  34  73  6  23  76 38  18  103 96  42  1,161 
 
 
# trainers trained 287  356  690  133  713  178  113  254  710 337  244  794 660  661  896 
 
# media events  242  236  36  2,702  218  4,839  101  52  266 148  213  192 61  396  1,363 
 
 
# community education events 1,887  579  108  227  302  111  159  301  95 544  135  341 238  435  320 
                                              
OUTCOMES 
   
total # trainers who have ever 
 
conducted activities 
117  203  200  103  90  95  45  27  239 51  244  302 192  186  896 
 
# group sessions  1,825  383  195  300  131  99  319  92  177 378  72  496 263  883  1,136 
 
# beneficiaries at group 
sessions  36,114  9,654  12,757  7,438  10,552  7,752  9,734  7,324  16,462 7,286  1,375  14,924 6,824  34,921  53,641 
 
# one-on-one sessions  40,064  950  79  259  7,059  62  1,582  21  2,501 4,271  255  1,351 2,823  362  112,911 
 
total # beneficiaries educated  76,178  10,604  12,836  7,697  17,611  7,814  11,316  7,345  18,963 11,557  1,630  16,275 9,647   35,283  166,552 
 
estimated # people reached by 
community education events  50,161  53,856  13,452  7,724  215,500  22,798  33,346  48,081  16,951 18,717  8,249  74,656 34,062  346,598  130,097 
 
# complaints received  197  118  228  217  228  339  39  144  67 1,488  51  274 96  315  115 
 
# complaints referred for 
follow-up  53  49  69  47  113  38  21  28  18 771  16  98 39  222  42 
 
# complaints resulting in some 
action  DK  18  0  12  155  6  1  4  5 560  13  32 2  26  28 
 
Medicare $ recouped  DK  DK  $17,320  $0  $5,102  $787  $395  $461  $1,230 $7,653  $0  $16,007 $0  $21,256  $121,272 
 
Other $ recouped  $51,949  $1,086  $0  $1,079  $251,647  $3,723  $0  $0  $138,573 $0  $0  $32,263 $4,485  $0  $13,262 
 
Total $ recouped  $51,949  $1,086  $17,320  $1,079  $256,749  $4,510  $395  $461  $138,573 $7,653  $0  $48,270 $4,485  $21,256  $134,534 
 
 7. Ohio-Western Reserve Area on Aging Project ended December 31, 2002           8.  Baylor University, TX: project ended June 30, 2002               9.  The National Hispanic Council on Aging, TX  APPENDIX C 
36-Month Outcomes Reported by the 7 Senior Medicare Patrol Projects beginning July 1, 2000 
Activity  TOTAL  LA  MS  NC  NE  SC  SD  WY 
OUTPUTS 
# training sessions 
438  17  75  285  36  13  6  6 
# trainers trained 
2,986  196  414  1,415  443  167  168  183 
# media events 
1,097  58  67  192  705  10  34  31 
# community education events  1,150  64  250  470  184  71  26  85 
OUTCOMES 
total # trainers who have ever 
conducted activities 
817  60  195  171  311  37  15  28 
# group sessions 
1,049  96  287  253  203  52  60  98 
# beneficiaries at group sessions 
33,541  1,646  8,776  8,202  7,632  2,018  1,611  3,656 
# one -on-one sessions 
11,151  268  7,589  1,297  658  91  197  1,051 
total # beneficiaries educated  44,692  1,914  16,365  9,499  8,290  2,109  1,808  4,707 
estimated # people reached by 
community education events 
286,421  3,281  31,698  42,036  185,011  12,207  2,732  9,456 
# complaints received 
905  53  450  209  50  79  12  52 
# complaints referred for 
follow up 
237  13  32  77  26  59  3  27 
# complaints resulting in some 
action 
122  7  31  29  9  21  2  23 
Medicare $ recouped 
$664,510  $0  $841  $140  $643,465  $7,274  $0  $12,790 
Other $ recouped 
$14,988  $0  $1,543  $108  $120  $0  $0  $13,217 
Total $ recouped  $679,498  $0  $2,384  $248  $643,585  $7,274  $0  $26,007  APPENDIX D 
24-Month Outcomes Reported by the 4 Senior Medicare Patrol Projects beginning July 1, 2001 
Activity  TOTAL  KY  NJ  TN  WV 
OUTPUTS 
# training sessions  165  88  6  67  4 
# trainers trained  540  213  47  273  7 
# media events  698  288  10  372  28 
# community education events  339  169  14  134  22 
OUTCOMES 
total # trainers who have ever 
conducted activities  357  192  35  123  7 
# group sessions  908  509  110  282  7 
# beneficiaries at group sessions  28,574  13,321  5119  10,099  35 
# one -on-one sessions  2,711  1,966  28  711  6 
total # benefi ciaries educated  31,285  15,287  5,147  10,810  41 
estimated # people reached by 
community education events  79,914  56,536  9,050  13,928  400 
# complaints received  166  63  50  53  0 
# complaints referred for 
follow up  35  2  6  27  0 
# complaints resulting in some 
action  12  0  3  9  0 
Medicare $ recouped  261  $0  $261  $0  $0 
Other $ recouped  $5,362  $0  $0  $5,362  $0 
Total $ recouped  $5,623  $0  $261  $5,362  $0  APPENDIX E 
12-Month Outcomes Reported by the 4 Senior Medicare Patrol Projects beginning July 1, 2002 
Activity  TOTAL  AR10  OH11  OH12  TX13 
OUTPUTS 
# training sessions  17  1  6  5  5 
# trainers trained  144  7  44  55  38 
# media events  992  1  100  882  9 
# community education events  285  13  108  19  145 
OUTCOMES 
total # trainers who have ever 
conducted activities  58  2  16  15  25 
# group sessions  113  5  14  39  55 
# beneficiaries at group sessions  2,570  160  245  834  1,331 
# one -on-one sessions  55  0  16  12  27 
total # beneficiaries educated  2,625  160  261  846  1,358 
estimated # people reached by 
community education events  24,005  1,400  11,874  3,333  7,398 
# complaints received  64  3  0  7  54 
# complaints referred for 
follow up  32  0  0  2  30 
# complaints resulting in some 
action  6  0  0  0  6 
Medicare $ recouped  $24,990  $0  $0  $0  $24,990 
Other $ recouped  $0  $0  $0  $0  $0 
Total $ recouped  $24,990  $0  $0  $0  $24,990 
10. Arkansas Dept. of Human Services  11. Central Ohio Area Agency on Aging  12. Pro-Seniors, Inc., OH  13. Better Business Bureau Education Foundation, TX