2024 Performance Data for the Senior Medicare Patrol Projects

Why OIG Did This Review

• The Senior Medicare Patrol (SMP) projects receive grants from ACL to recruit and train retired professionals and other older adults and community members to prevent, detect, and report Medicare fraud, errors, and abuse. These SMP team members participate in outreach events to help educate Medicare and Medicaid beneficiaries on the same prevention, detection, and reporting techniques.
• OIG has reported performance data for the SMP on an annual basis since 1997 to support the efforts of ACL to evaluate and improve its performance.

What OIG Found

In 2024, the 54 SMP projects:

• had 5,643 active team members;
• conducted 22,752 group outreach and education events; and
• had 283,724 individual interactions with, or on behalf of, a Medicare beneficiary.

The projects also had the following results:

• $35,115,211 in expected Medicare recoveries that were attributable to the projects;
• $99,037 in cost avoidance on behalf of Medicare, Medicaid, beneficiaries, and others; and
• $6,071 in total savings to beneficiaries and others.

What OIG Concludes

We note that the projects may not be receiving full credit for recoveries, savings, and cost avoidance attributable to their work. It is not always possible to track referrals to Medicare contractors or to law enforcement from beneficiaries who have learned to detect fraud, waste, and abuse from the projects. In addition, the projects are unable to track the potentially substantial savings derived from a sentinel effect, whereby Medicare beneficiaries’ scrutiny of their bills reduces fraud and errors.

Nonetheless, ACL needs to work with SMP projects to further focus on and document expected Medicare and Medicaid recoveries; additional Medicare and Medicaid recoveries; cost avoidance; and savings both to beneficiaries and to others to the extent possible.