East Tennessee Human Resource Agency

Senior Medicare Fraud Patrol

The purpose of the Senior Medicare Fraud Patrol Project is to reduce Medicare waste and abuse by increasing public awareness through educational programs and by assisting the beneficiary in reading and understanding Medicare documents and how to report suspicious claims.

Eligibility

Recipient of Medicare benefits.

Top 3 Goals

  1. To educate the Medicare beneficiary how to protect her health care benefits.
  2. To educate the Medicare beneficiary what she can do to help fight fraud, waste and abuse.
  3. To educate the Medicare beneficiary why she should report suspected fraud, waste and abuse and to assist the beneficiary in reporting the alleged fraud, waste and abuse.

Explanation of Services

The Tennessee Commission on Aging and Disability through a contract with the Upper Cumberland Area Agency on Agency provides the East Tennessee Human Resource Agency with the funds to recruit, train, certify and assign volunteer educators/advocates to serve in the Medicare Fraud Patrol.

The volunteer educator travels throughout her assigned county meeting and speaking with Medicare beneficiaries at Senior Adult Centers, Nutrition Program Sites, Church Senior Groups, AARP Units, Retired Workers Associations, and other sites that cater to elders.

The volunteer advocate assists Medicare beneficiaries with the reading and interpretation of Medicare forms at the centers listed in the preceding paragraph. The Medicare beneficiary makes an appointment to meet with the volunteer advocate at a mutually arranged time and place in the county.

The Medicare Fraud Patrol Project receives technical assistance from the national Center for Medicare/Medicaid System and distributes pamphlets and other educational materials provided by CMS to Medicare beneficiaries. The Medicare Fraud Patrol Project works closely with CMS, Riverbend Government Benefits Administrator, Palmetto Government Benefits Administrator, Social Security Administration, and Mid-South Foundation for Medical Care.

Number of Persons Served

The Medicare Fraud Patrol Project serves all Medicare beneficiaries in sixteen (16) counties of East Tennessee. There are approximately 190,000 persons aged 65 and above in East Tennessee. These are our clients.

Source of Funding

Federal funds are made available through the Tennessee Commission on Aging and Disability.

Counties Served

Anderson, Blount, Campbell, Claiborne, Cocke, Grainger, Hamblen, Jefferson, Knox, Loudon, Morgan, Monroe, Roane, Scott, Sevier and Union.

For More Information Please Contact: Cindy Troyer at (865) 691-2551 ext. 212 or by E-mail at CTroyer@ethra.org.