Georgia Senior Medicare Patrol State Project Grants - Scam artists have become increasingly savvy: seniors are being contacted through the internet, telephone, social media, e-mail, and text. Scams have included fraud related to ambulance service, durable medical equipment, cardiac genetic testing, COVID-19, DNA genetic testing, home health, hospice, insurance plans, skilled nursing, prescription drugs, vaccines, and others with new scams being identified frequently. In 2022, there were three major Medicare fraud cases pursued in Georgia: one for prescribing medically unnecessary durable medical equipment, one for fraudulent telemedicine charges targeting older adults, and one for submitting false claims for genetic and laboratory testing, the total of which involved over $474 million in fraudulent Medicare charges. Seniors need GA SMP to help them detect and report these types of Medicare scams. As the current GA SMP, the AdviseWell team understands Georgia seniors and has extensive and successful experience spreading the SMP message statewide. AdviseWell is mindful of the existing and rapidly changing Medicare enrollment landscape in Georgia. Our goal is to successfully provide innovative and adaptable education, outreach, and counseling by understanding GA’s unique population, leveraging critical statewide collaborations, and deploying our trained and experienced workforce of team members to empower beneficiaries to prevent, detect, and report healthcare fraud, errors and abuse. Objectives include: improve outreach, education and support utilizing data to ensure statewide reach; provide appropriate timely outreach/education through various communication mediums; recruit and retain a trained workforce to provide quality education and support; provide comprehensive, timely, and accurate data documentation for ongoing Plan, Do, Study, Act response; enable GA’s workforce to quickly adapt to state environmental, population, and/or ACL SMP program changes through knowledge of GA’s population, relationships with key stakeholders, resources, and ability to be flexible in communication efforts. Anticipated outcomes: beneficiaries will experience appropriate SMP interventions demonstrated by improved understanding and empowerment; beneficiaries/communities will be able to find and use SMP education, counseling, and support through various communication mediums; a trained workforce will cultivate and build community relationships for statewide outreach; comprehensive operational and quality measures will drive optimal appropriate outreach and outcomes; workforce will be able to adapt and respond to State and/or program changes. Expected products are SMP training and marketing material, webinars, podcasts, fraud alerts, Resource and Volunteer Training Toolkits.
