George Grob /S/ 

Deputy Inspector General 

for Evaluation and Inspections 

Three Year and One Year Performance Data for the Senior Medicare Patrol Projects

(OEI-02-97-00527)

Edwin Walker, Director

Office of Program Operations and Development

Administration on Aging

At the request of the Administration on Aging (AoA), we have continued to collect

performance data from the 12 original Senior Medicare Patrol Projects and the 29 new Senior

Medicare Patrol Projects. Attachment A presents performance data for the entire three years

of the original projects. Attachment B presents performance data for the first year of the new

projects. Please note these data are self-reported and we have not verified their accuracy.

Having just finished their three year grant period, the original 12 Senior Medicare Patrol

Projects have accomplished much in training and educating beneficiaries about fraud, waste,

and abuse. They trained close to 12,000 trainers who later went on to educate about 198,000

beneficiaries. They also reached an estimated 42 million through community education events

and the media. These beneficiaries are trained to scrutinize their Medicare bills and summary

notices and to report potential errors to their medical care providers, Medicare insurance

contractors, or the Office of Inspector General (OIG) fraud hotline. 

In addition, these projects received 7,600 complaints through one-on-one counseling with

beneficiaries and through their own local hotlines. Of the complaints that were investigated,

the projects helped identify a total of $1.5 million in Medicare funds for recoupment. 

However, projects were able to provide documentation of actual recoupment for only

$261,000. It is important to note that the projects continue to have difficulty tracking such

recoupments.

As for the 29 new Senior Medicare Patrol Projects, they have made significant progress in the

past six months. The total number of trainers they have trained has more than doubled in the

past 6 months, from 934 to 2,463. The total number of beneficiaries educated by these trainers

has tripled, from 22,267 to 65,139. The complaints the projects have received and the money

identified for recoupment have also shown large increases. Currently, the projects have

received 1,334 complaints and have identified $85,000 in Medicare funds for recoupment. 

However, projects have not been able to provide documentation of any actual recoupments.
Page 2 - Edwin Walker, Director 

As a whole, the Senior Medicare Patrol Projects have trained 14,408 trainers and educated 

262,913 Medicare beneficiaries through sessions. It should be noted that the most substantial 

savings which are expected to arise from projects under both of the above programs will be 

derived from a sentinel effect whereby fraud and error are reduced in light of Medicare 

beneficiaries' scrutiny of their bills. Savings will also result from reports of fraud and error 

made to the Medicare contractors and to the OIG fraud hotline. It is not feasible, however, to 

track these effects entirely. 

We will continue to monitor the projects and provide you with 40-month and 18-month 

performance data. If you have any questions, please call me at (202) 619-0480 or have your 

staff call Jack Molnar at (212) 264-1998. 

Attachments 
APPENDIX A 

Three Year 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 726 55 16 22 19 57 52 12 7 389 41 9 47 

# trainers trained 11,945 734 129 859 235 855 332 49 303 7,620 76 228 525 

# media events 2,325 147 67 366 74 137 293 49 735 167 41 113 136 

# community education events 2,255 0 42 85 110 513 301 100 113 594 264 30 103 

OUTCOMES 

total # trainers who have ever 3,245 236 45 DK 235 16 92 49 20 2,362 50 23 117 

conducted activities 

# group sessions 4,439 802 126 439 1,070 35 348 84 318 466 343 193 215 

# beneficiaries at group sessions 183,529 41,108 5,512 16,174 39,668 5,200 7,543 3,501 5,724 19,894 28,590 4,101 6,514 

# one-on-one sessions 14,245 564 0 112 422 2,799 350 1,130 6,006 2,384 375 DK 103 

total # beneficiaries educated 197,774 41,672 5512 16,286 40,090 7,999 7,893 4,631 11,730 22,278 28,965 4,101 6,617 

estimated # people reached by media 33,356,284 4,876,510 271,183 1,000,000 10,424,000 195,000 195,648 140,000 950,000 663,108 2,030,000 7,548,300 5,062,535 

events 

estimated # people reached by 8,496,421 0 2,578 11,646 6,675 33,725 13,411 140,000 15,003 239,436 8,005,000 13,593 15,354 

community education events 

# complaints received 7,611 564 19 725 195 625 185 17 4,688 183 310 28 72 

# complaints referred for follow-up 1,033 146 3 298 73 137 106 15 41 56 88 27 43 

# complaints resulting in some action 266 27 0 22 DK 98 26 DK 14 37 24 DK 18 

Medicare $ recouped 1,522,725 113,722 0 DK DK DK 0 3,008 144,164 DK 1,145,767 * 109,997 * 6,067 * 

Other $ recouped 626,923 34,000 0 58,691 146,485 DK 15,805 177,724 180,075 0 DK DK 14,143 

Total $ recouped 2,149,648 147,722 0 1,204,458 146,485 DK 125,802 177,724 180,075 3,008 144,164 DK 20,210 

Please note the following:

--New York is also a HIPAA-funded Project grantee.

* Pending documentation of actual recoupments 
One Year Outcome Reported by New Senior Medicare Patrol Projects APPENDIX B 

Activity TOTAL AK AL AR AZ CO CT DC DC DE FL GA GA ID IN 1 2 3 4 

OUTPUTS 

# training sessions 288 38 7 1 6 14 1 7 0 4 3 4 8 9 0 

# trainers trained 2,463 42 101 12 8 131 6 29 0 36 31 40 102 23 0 

# media events 1,264 28 11 2 3 11 14 7 0 791 23 0 2 2 0 

# community education events 1,020 33 24 46 42 18 0 13 14 26 38 1 29 28 0 

OUTCOMES 

total # trainers who have ever 504 35 18 2 8 16 6 7 0 16 7 40 33 13 0 

conducted activities 

# group sessions 1,225 5 12 5 21 152 32 18 0 33 4 32 87 37 0 

# beneficiaries at group sessions 54,111 141 625 185 5,981 5,618 2,500 639 0 769 51 1,371 2,971 647 0 

# one-on-one sessions 11,028 996 89 DK 4 52 0 8 0 2 77 0 2 31 0 

total # beneficiaries educated 65,139 1,137 714 185 5,985 5,670 2,500 647 0 771 128 1,371 2,973 678 0 

estimated # people reached by media 11,776,346 80,000 100,450 40,000 22,000 420,098 161,500 55,000 0 106,988 1,262,589 0 20,000 450 0 

events 

estimated # people reached by 90,646 1,500 1,920 2,950 8,655 2,220 0 2,275 412 3,552 7,398 60 3,002 1,122 0 

community education events 

# complaints received 1,334 321 22 1 281 21 10 30 0 36 14 0 0 114 0 

# complaints referred for follow-up 448 2 17 1 15 5 10 7 0 2 7 0 0 76 0 

# complaints resulting in some action 195 0 2 0 DK DK 0 0 0 0 1 0 0 28 0 

Medicare $ recouped 85,225 0 0 0 DK DK 0 0 0 0 0 0 0 0 10,970 * 

Other $ recouped 25,170 9,887 0 0 DK DK 0 0 0 0 0 0 0 0 0 

Total $ recouped 110,395 9,887 0 0 DK DK 0 0 0 0 0 0 0 10,970 0 

Please note the following: 

— The new Senior Medicare Patrol Projects in AZ, OR, and VA are also HIPAA-funded Project grantees. 

Please note these distinctions: 

1. The AARP Foundation, DC 2. Friendship House, DC 3. Atlanta Regional Commission, GA 4. Department of Human Resources, GA 

* Pending documentation of actual recoupments 
One Year Outcome Reported by New Senior Medicare Patrol Projects APPENDIX B 

Activity MA ME M I MT NM NV OH OK OR PR TX TX UT VA WA 5 6 

OUTPUTS 

# training sessions 18 10 17 2 2 23 2 1 11 6 6 12 5 11 60 

# trainers trained 108 59 231 15 50 30 63 12 61 50 102 36 39 208 838 

# media events 101 19 3 11 19 20 37 2 26 12 4 20 3 76 17 

# community education events 43 48 2 34 31 15 43 25 10 300 12 57 8 78 2 

OUTCOMES 

total # trainers who have ever 24 11 18 0 9 8 41 3 27 3 20 22 5 73 39 

conducted activities 

# group sessions 73 8 43 0 7 13 84 1 28 0 7 50 15 195 263 

# beneficiaries at group sessions 2,194 481 2,873 0 210 450 3,062 1,168 538 0 510 1,163 350 5,540 14,074 

# one-on-one sessions 1,283 8 0 0 23 12 196 0 21 5 0 137 42 0 8,040 

total # beneficiaries educated 3,477 489 2,873 0 233 462 3,258 1,168 559 5 510 1,300 392 5,540 22,114 

estimated # people reached by media 137,000 546,700 1,100 22,760 168,000 3,110,332 1,004,987 20,100 1,406,250 650,000 500,000 1,025,000 1,700 901,932 11,410 

events 

estimated # people reached by 370 3,511 150 849 9,312 1,370 4,990 2,077 5,294 4,000 1,500 2,336 2,400 17,271 150 

community education events 

# complaints received 5 11 105 0 24 38 6 0 1 150 0 35 0 90 19 

# complaints referred for follow-up 1 7 41 0 7 7 1 0 1 150 0 8 0 71 12 

# complaints resulting in some action DK 0 DK 0 7 2 0 0 1 140 0 2 0 DK 12 

Medicare $ recouped DK 0 0 0 0 DK DK 0 0 0 DK 17,269 * 4,927 * 787 * 51,272 * 

Other $ recouped 8,626 0 2,466 0 382 3,723 0 0 DK DK 0 86 0 DK 0 

Total $ recouped 8,626 0 19,735 0 5,309 4,510 0 0 DK DK 0 86 0 DK 51,272 

Please note the following:

-- The new Senior Medicare Patrol Projects in AZ, OR, and VA are also HIPAA-funded Project grantees. 

Please note these distinctions:

5. Baylor University, TX 6. The National Hispanic Council on Aging, TX 

*Pending documentation of actual recoupments