Medicare Watch

Armed with New Tools, CMS Aims to Stop Fraud Before It Happens

The way Medicare fights fraud is about to change, according to the Centers for Medicare & Medicaid Services (CMS). The Affordable Care Act provides CMS with new tools that are designed to help root out fraud before it happens. This new focus on prevention is a marked departure from CMS’s traditional methods. In the past, the agency has focused on catching fraudsters after fraud has been committed.

Two new fact sheets, posted on HealthCare.gov, outline the new tools that are available under health reform, all of which enhance identification and prevention of fraud. Data-sharing among a wide range of agencies will be improved, and CMS will be better able to screen suppliers and providers before they enroll in Medicare. CMS will also have greater authority to act on suspected fraud by suspending payments to suppliers and providers and terminating their enrollment in Medicare if necessary. The Affordable Care Act also toughens sentences for people who commit fraud.

Read a fact sheet on Medicare fraud.

Read about the new tools to fight fraud.

A Makeover for Medicare Interactive

Medicare Interactive, the Medicare Rights Center’s free online resource, has a new look. The site now features a cleaner design, a more intuitive layout and improved navigational tools. “We’re delighted to offer a more streamlined Medicare Interactive,” said Medicare Rights President Joe Baker. He noted that the launch of the redesigned site comes at a critical time—just before the beginning of the fall open enrollment period on November 15.

Visitors to Medicare Interactive will find the same clear and accurate content that makes the tool a go-to source for Medicare information. But now they can search the site in three ways: by keyword or phrase in the FIND bar, by general topic in the Table of Contents and by specific topic in the keyword list of popular topics.

Medicare Interactive receives more than 400,000 visits each year from consumers, caregivers and the professionals who help them.

Visit the site at www.MedicareInteractive.org.

Medicare Reminder

Medicare covers 100 percent of the cost of a flu shot once every flu season, with no Part B deductible required, if you go to a doctor or other health care provider who accepts assignment.

This week, Secretary of Health and Human Services Kathleen Sebelius urged consumers to prepare for the flu season by getting vaccinated now. Unlike last year, when two separate vaccines were available—one for seasonal flu and one for H1N1, or “swine flu”—this year’s vaccine will protect against both strains.

Read more about how Medicare covers flu shots at www.MedicareInteractive.org.

Read HHS Secretary Sebelius’s announcement.

Spotlight

Two recent studies shed light on how the Medicare prescription drug program (Part D) works for people with low income. A study by Avalere, a private research firm, found that next year, people with low income will see an increase in the number of drug plans they can choose from. A report by the Kaiser Family Foundation takes a look at Extra Help, the federal program that helps people pay for their prescription drugs, and offers recommendations for the future.

Read Avalere’s press release.

Read the Kaiser Family Foundation’s report.