DEPARTMENT OF HEALTH & HUMAN SERVICES 
Office of Inspector General 
Memorandum 
March 19, 2003 
Date: 
John I. Molnar 
From: 
Regional Inspector General for 
Evaluation and Inspections  New York 
Performance Data for the Senior Medicare Patrol Projects: March 2003 Performance 
Subject: 
Report (OEI-02-03-00120) 
Brian Lutz, Director 
To:	
Office of Community-Based Services 
Administration on Aging 
At the request of the Administration on Aging (AoA), the Office of Inspector General collects 
performance data for the Senior Medicare Patrol Projects. The attachments present cumulative 
performance data from the beginning of each project. Attachment A lists complete data for the 
12 projects that have operated since the inception in 1997.  Attachment B presents the 
cumulative 312 years of work for 29 projects. Attachment C reflects performance data for 7 
projects with 30 months of experience. Attachment D contains the first 18 months of data for 4 
projects. Attachment E introduces 6 months of data for the 4 new projects. Please note that 
the project data are self-reported and that we have not independently verified their accuracy. 
As of December 31, 2002, there are 54 Senior Medicare Patrol Projects operating. 
Additionally, two projects -- Arkansas Seniors Organized for Progress and Texas-Baylor 
University -- are no longer in operation as of June 30, 2002. Since the inception of the first 
projects in 1997, a total of 34,700 volunteers have been trained to detect Medicare fraud, 
waste, and abuse.  In-turn, these volunteers have conducted 200,495 training sessions in which 
almost 1.1 million Medicare beneficiaries were educated. Once educated, these beneficiaries 
reported 23,142 complaints, of which 5,332 were referred for follow-up. Investigative 
agencies took action on 2,312 of these referrals. In total, closed investigations have resulted in 
the recoupment of $3,679,644 in Medicare funds and, reportedly, $77,446,583 to other 
payors. 
Over the past 6 months, the 54 projects that are currently operating have trained a total of 
3,531 new volunteers. Approximately 231,000 beneficiaries were educated at 46,243 training 
sessions conducted by volunteers. A total of 3,800 complaints have been registered since June  2002. Documentation received in the past 6 months provides evidence of $670,868 in 

Medicare funds recouped as a direct result of the projects. 

Page 2  Brian Lutz

Another $825,028 has been recouped to other payors.

Of the 54 current grantees, 11 reported savings in the past 6 months. Six of these grantees 

submitted Centers for Medicare & Medicaid Services contractor-based complaint tracking 

system reports. Of the money reported recouped in the past 6 months, $7,807 were 

documented by the tracking reports. 

We continue to note 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 saved funds 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.

At this time, we encourage AoA to develop a strategy to continue monitoring the Senior 

Medicare Patrol Projects.  We are fully prepared to work with AoA to develop and implement 

that strategy.  If you have any questions, please call me at 212-264-2000.

Attachments
 APPENDIX A 
66-Month Outcomes Reported by the Senior Medicare Patrol Projects

Activity  TOTAL  CA  HI  IA  IL  MD  MN  MO  NH  NY  PA  RI  WI 
OUTPUTS 
# training sessions  1,583  99  59  273  29  250  90  41  17  557  76  12  80 
# trainers trained  21,486  2,190  284  2,455  272  2,677  569  205  697  10,698  267  252  920 
# media events  25,477  214  4,563  2,559  3,706  323  454  68  1,098  409  67  7,904  4,112 
# community education events  5,812  89  68  824  347  1,438  850  221  220  1,108  329  81  237 
OUTCOMES 
total # trainers who have ever 
conducted activities  6,310  393  145  DK  249  108  278  205  541  3,971  161  26  233 
# group sessions  10,144  1,725  331  1,595  1,548  1,109  824  228  438  967  673  281  425 
# beneficiaries at group sessions  443,831  74,838  11,169  52,326  62,538  26,148  15,480  11,788  52,565  32,429  84,868  6,753  12,929 
# one -on-one sessions  56,369  697  0  237  539  11,066  579  13,212  20,570  8,846  375  1  247 
total # beneficiaries educated  500,200  75,535  11,169  52,563  63,077  37,214  16,059  25,000  73,135  41,275  85,243  6,754  13,176 
estimated # people reached by 
community education events  9,231,249  48,311  26,064  327,198  27,316  85,008  27,435  247,419  63,779  263,367  8,010,456  68,923  35,973 
# complaints received  11,518  793  218  1,153  349  1,553  352  44  4,784  960  1,031  53  228 
# complaints referred for 
follow -up  1,860  262  46  412  105  243  157  42  111  235  101  39  107 
# complaints resulting in some 
action  650  56  DK  43  10  104  68  13  40  220  41  6  49 
Medicare $ recouped  $2,778,613  $1,318,913  DK  $1,147,524  $0  DK  $109,997  $210  $107  $45,797  $144,339  $0  $11,726 
Other $ recouped  $76,623,778  $74,914  DK  $1,324,867  $146,485  DK  $31,681 $1,708,530  $119,407 $73,201,200  $1,935  $0  $14,759 
Total $ recouped  $79,402,392  $1,393,827  $0  $2,472,391  $146,485  $0  $141,678 $1,708,740  $119,514 $73,246,997  $146,274  $0  $26,485  APPENDIX B 
42-Month Outcomes Reported by the Senior Medicare Patrol Projects

Activity  TOTAL  AK  AL  AR1  AZ  CO  CT  DC2  DC3  DE  FL  GA4  GA5  ID  IN 
OUTPUTS 
# training sessions 
2,493  58  88  12  40  35  22  13  5  39  31  61  276  193  14 
# trainers trained 
10,204  122  331  129  123  212  225  63  47  306  224  170  1,938  638  240 
# media events 
16,570  47  118  35  519  46  856  34  20  4,714  972  53  1,083  2,128  49 
# community education events  7,931  65  292  91  377  558  714  46  20  127  167  26  1,552  208  124 
OUTCOMES 
total # trainers who have ever 
conducted activities 
4,658  83  331  43  123  34  84  63  25  84  137  154  755  200  24 
# group sessions 
9,850  45  399  92  352  404  120  191  75  348  188  414  1,834  772  56 
# beneficiaries at group 
sessions 
434,411  1,410  19,605  8,787  53,578  11,120  3,862  6,104  2,681  8,755  13,041  11,462  58,737  41,064  1,686 
# one -on-one sessions 
113,465  2,320  437  51  259  189  48  11  623  75  461  789  1,063  861  50 
total # beneficiaries educated  547,876  3,730  20,042  8,838  53,837  11,309  3,910  6,115  3,304  8,830  13,502  12,251  59,800  41,925  1,736 
estimated # people reached by 
community education events 
2,548,176  31,376  50,946  9,673  64,164  19,498  38,111  186,800  7500  134,133  176,961  4,316 1,042,918  11,750  22,707 
# complaints received 
10,759  445  225  50  1,981  153  127  365  48  132  564  43  33  3,140  8 
0 
# complaints referred for 
follow -up 
3,231  22  104  14  149  17  34  54  25  21  7  18  1,289  8 
0 
# complaints resulting in some 
action 
1,551  7  13  DK  22  DK  3  10  1  9  0  4  669  2 
Medicare $ recouped 
$231,720  $0  $0  DK  $429  $453  $29,446  $1,329  $0  $5,388  $4,601  $0  $0  $10,970  $4,441 
Other $ recouped 
$807,640  $13,495  $0  DK  $3,271  $3,450  $0  $0  $0  $0  $66,098  $0  $0  $452,699  $0 
Total $ recouped  $1,039,360  $13,495  $0  $0  $3,700  $3,903  $29,446  $1,329  $0  $5,388  $70,699  $0  $0  $463,669  $4,441 
Please note these distinctions: 
1. Project ended June 30, 2002  2. The AARP Foundation, DC  3. Friendship House, DC  4. Atlanta Regional Commission, GA  5. Department of Human Resources, GA  APPENDIX B 
42-Month Outcomes Reported by the Senior Medicare Patrol Projects

Activity  MA  ME  M I  MT  NM  NV  OH  OK  OR  PR  TX6  TX7  UT  VA  WA 
OUTPUTS 
# training sessions  100  79  43  20  22  63  6  11  75  30  18  87  53  37  962 
# trainers trained  227  254  643  80  453  147  113  108  690  325  244  679  197  620  656 
# media events  197  191  36  2,616  213  84  101  47  263  129  213  174  43  372  1,217 
# community education events  213  509  92  150  274  95  159  246  64  533  135  303  134  390  267 
OUTCOMES 
total # trainers who have ever 
conducted activities  109  158  198  54  70  90  45  25  219  43  244  286  142  179  656 
# group sessions  283  306  179  168  89  89  319  37  157  330  72  451  139  883  1,058 
# beneficiaries at group 
sessions  10,150  7,203  12,218  3,445  9,713  7,370  9,734  6,569  15,472  6,223  1,375  14,713  4,809  32,577  50,948 
# one -on-one sessions  3,368  743  67  138  4,411  47  1,582  18  1,216  3,941  255  1,083  1,970  362  87,027 
total # beneficiaries educated  13,518  7,946  12,285  3,583  14,124  7,417  11,316  6,587  16,688  10,164  1,630  15,796  6,779  32,939  137,975 
estimated # people reached by 
community education events  17,410  31,130  11,932  3,468  207,760  19,473  33,346  40,088  14,038  18,297  8,249  48,106  28,471  146,598  118,957 
# complaints received  197  78  216  159  175  286  39  79  62  1,464  51  180  83  281  95 
# complaints referred for 
follow -up  53  47  66  15  60  34  21  28  18  758  16  67  39  211  36 
# complaints resulting in some 
action  DK  16  N/A  0  139  2  1  4  5  551  13  29  2  25  24 
Medicare $ recouped  DK  DK  $17,320  $0  $5,102  $787  $395  $0  DK  $6,607  $0  $2,516  $0  $20,664  $121,272 
Other $ recouped  $51,949  DK  $0  $1,079  $163,313  $3,723  $0  $0  DK  $0  $0  $30,816  $4,485  DK  $13,262 
Total $ recouped  $51,949  $0  $17,320  $1,079  $168,415  $4,510  $395  $0  $0  $6,607  $0  $33,332  $4,485  $20,664  $134,534 
Please note these distinctions: 
6. Baylor University, TX: project ended June 30, 2002  7. The National Hispanic Council on Aging, TX  APPENDIX C 
30-Month Outcomes Reported by the Senior Medicare Patrol Projects

Activity  TOTAL  LA  MS  NC  NE  SC  SD  WY 
OUTPUTS 
# training sessions 
353  14  43  248  31  9  3  5 
# trainers trained 
2,597  142  361  1,277  421  115  133  148 
# media events 
964  42  57  115  679  10  32  29 
# community education events  783  52  166  319  94  51  23  78 
OUTCOMES 
total # trainers who have ever 
conducted activities 
698  58  183  126  263  29  15  24 
# group sessions 
823  88  224  169  160  44  50  88 
# beneficiaries at group sessions 
25,538  1,325  6,367  5,225  6,490  1,568  1,260  3,303 
# one -on-one sessions 
8,199  190  6,682  649  502  83  8  85 
total # beneficiaries educated  33,737  1,515  13,049  5,874  6,992  1,651  1,268  3,388 
estimated # people reached by 
community education events 
255,326  3,049  21,106  31,107  178,440  10,107  2,392  9,125 
# complaints received 
790  45  418  161  39  76  12  39 
# complaints referred for 
follow -up 
205  10  24  66  19  56  3  27 
# complaints resulting in some 
action 
101  5  16  29  5  21  2  23 
Medicare $ recouped 
$664,383  $0  $714  $140  $643,465  $7,274  $0  $12,790 
Other $ recouped 
$14,979  $0  $1,534  $108  $120  $0  $0  $13,217 
Total $ recouped  $679,362  $0  $2,248  $248  $643,585  $7,274  $0  $26,007  APPENDIX D 
18-Month Outcomes Reported by the Senior Medicare Patrol Projects

Activity  TOTAL  KY  NJ  TN  WV 
OUTPUTS 
# training sessions  143  83  5  55  0 
# trainers trained  397  137  39  221  0 
# media events  542  223  8  285  26 
# community education events  221  129  4  70  18 
OUTCOMES 
total # trainers who have ever 
conducted activities  168  128  13  27  0 
# group sessions  523  315  49  159  0 
# beneficiaries at group sessions  15,383  8,228  1372  5,783  0 
# one -on-one sessions  1,121  716  8  397  0 
total # beneficiaries educ ated  16,504  8,944  1,380  6,180  0 
estimated # people reached by 
community education events  64,110  53,203  3,250  7,004  653 
# complaints received  69  4  26  39  0 
# complaints referred for 
follow -up  30  2  6  22  0 
# complaints resulting in some 
action  9  0  3  6  0 
Medicare $ recouped  $261  $0  $261  $0  $0 
Other $ recouped  $186  $0  $0  $186  $0 
Total $ recouped  $447  $0  $261  $186  $0  APPENDIX E 
6-Month Outcomes Reported by the Senior Medicare Patrol Projects

Activity  TOTAL  AR1  OH2  OH3  TX4 
OUTPUTS 
# training sessions  2  0  0  0  2 
# trainers trained  16  0  0  0  16 
# media events  81  0  55  20  6 
# community education events  85  0  25  16  44 
OUTCOMES 
total # trainers who have ever 
conducted activities  1  0  0  0  1 
# group sessions  0  0  0  0  0 
# beneficiaries at group sessions  0  0  0  0  0 
# one -on-one sessions  1  0  0  0  1 
total # beneficiaries educated  1  0  0  0  1 
estimated # people reached by 
community education events  3,264  0  594  29  2,641 
# complaints received  6  0  0  0  6 
# complaints referred for 
follow -up  6  0  0  0  6 
# complaints resulting in some 
action  1  0  0  0  1 
Medicare $ recouped  $4,667  $0  $0  $0  $4,667 
Other $ recouped  $0  $0  $0  $0  $0 
Total $ recouped  $4,667  $0  $0  $0  $4,667 
Please note these distinctions:  1. Arkansas Dept. of Human Services  2. Pro-Seniors, Inc., OH  3. Central Ohio Area Agency on Aging  4. Better Business Bureau Education Foundation, TX