Office for the Aging


NYSOFA: The Best Advice is to Be Diligent!

With new health care options becoming available in New York State beginning October 1, 2014, the New York State Office for the Aging (NYSOFA) is offering the following advice on preventing health care fraud and abuse. Senior Medicare Patrol programs (SMP), help Medicare and Medicaid beneficiaries avoid, detect, and prevent health care fraud. In doing so, they not only protect older persons, they also help preserve the integrity of the Medicare and Medicaid programs.

"Working with the SMP program, older adults can save thousands of dollars and learn how to protect themselves from being scammed, losing their identity, or paying for services and procedures that were not delivered," said Greg Olsen, Acting Director for NYSOFA. "By reporting possible fraud and abuse, caregivers and clients can help save these important programs a lot of money by ensuring that only those services delivered are reimbursed."

Protect: Protecting your personal information is the best line of defense in the fight against healthcare fraud and abuse. Every day, consumers get ripped off by scam artists. Medicare and Medicaid lose billions of dollars each year. You can make a difference! Here are some ways to take an active in protecting your healthcare benefits:

  • Treat your Medicare, Medicaid and Social Security numbers like a credit card number. Never give these numbers to a stranger.
  • Remember, Medicare doesn't call or visit to sell you anything.
  • Don't carry your Medicare or Medicaid card unless you will need it. Only take it to doctor's appointments, visits to your hospital or clinic, or trips to the pharmacy.
  • Record doctor visits, tests and procedures in your personal health care journal or calendar.
  • Save Medicare Summary Notices and Part D Explanation of Benefits. Shred the documents when they are no longer useful.

Even when you do everything right, there is a chance that you could be a target of healthcare fraud. There are a lot of ways that your personal information can be used without your permission. Here are some steps you can take to detect potential errors, fraud and abuse:

  • Always review your Medicare Summary Notice (MSN) and Part D Explanation of Benefits (EOB) for mistakes.
  • Access to your current Medicare account is available 24 hours a day, simply visit Link)
  • Compare your MSN and EOB to your personal health care journal and prescription drug receipts to make sure they are correct.
  • Look for three things on your billing statement:
    • Charges for something you didn't get
    • Billing for the same thing twice
    • Services that were not ordered by your doctor

If you suspect errors, fraud or abuse, report it immediately! You will protect other people from becoming victims and help to save your Medicare benefits. Here are the steps you should take to report your concerns and abuse:

  • If you have questions about information on your Medicare Summary Notice or Part D Explanation of Benefits, call your provider or plan first.
  • If you are not comfortable calling your provider or plan or you are not satisfied with the response you get, call your local SMP at 1-877-808-2468.