Fraud Alert - Illinois Senior Medicare Patrol
November 16th, 2020
An Oral History of the Illinois
Senior Medicare Patrol Program: Part 1
Over the course of the last four months, we have featured interviews from former directors, volunteers, partners and more celebrating the 25th Anniversary of the Illinois Senior Medicare Patrol. We only have three more Fraud Alert's left in 2020 which will feature the oral history of how the SMP program in Illinois was started, what it has currently grown into and what the future holds for the next 25 years!

Last month we got to speak with Bill Benson, former Acting Assistant Secretary for Aging under the Clinton Administration, and Jon Lavin, former CEO of AgeOptions, to discuss how the SMP Program came into existence at AgeOptions. Please enjoy Part 1 of our 3 part series, Part 1 being the Oral History of the Illinois Senior Medicare Patrol.


Jon Lavin:
At the 1995 White House Conference on Aging (WCHOA), President Bill Clinton talked about the federal government’s relative neglect of Medicare up to that point. As a result, there were major concerns related to the fraud and abuse that was occurring in the program with millions of dollars misdirected without serious examination. He said that his intent was to initiate a concerted effort to guard Medicare dollars in “Operation Restore Trust.”

Bill Benson:
As Jon and Diane (Slezak) know, I’ve been a huge fan of AgeOptions for decades due in large part to your commitment to protect the rights of older adults. I admired your Red Tape Cutters programs and thought it should have been replicated by Area Agencies on Aging (AAAs) everywhere.
 
First and foremost, let me weigh in a bit about the SMP program history of which I still have a huge file of original documents that I would love to find a home for haha!
 
There were two tracks related to Medicare fraud that were running reasonably close together. One was what became Operation Restore Trust (ORT) which was launched around the time of the 1995 WHCOA, as Jon notes. ORT was formed to go after Medicare fraud, which many were financial scams happening in nursing homes. led Adminstration on Aging’s (AoA) efforts with the aging network (including working with Suburban AAA now AgeOptions).

Jon Lavin:
One component of that program was the engagement of Medicare Beneficiaries to guard their own program. We received a small contract based on our work with a volunteer centered Red Tape Cutter Program to help define how older persons could inform each other on the practical steps needed to guard their benefits.

Bill Benson:
When I was the Acting Assistant Secretary for Aging, I believe in 1996, Senator Tom Harkin (D-IA) introduced his legislation which became the basis for the SMP program.

I went on a barn-storming trip across Iowa with Harkin and Peter Reinecke of his staff as he announced his plans to introduce the legislation to fight Medicare fraud with senior volunteers. I have some good stories from that trip that I hope I can share with you some time before they fade into oblivion. 
 
Harkin’s legislation passed and the first appropriation for the “Harkin grants” was made allowing us at AoA to make the first SMP grants in 1997.

Jon Lavin:
This program became the Senior Medicare Patrol. AgeOptions applied with the support of all 13 area agencies on aging to be the Illinois program and received the first grant!

Bill Benson:
The "Harkin Grants" provided 10 million dollars in 1997 to fund state SMP programs. Barbara Dikera was the original person who was in charge of SMP program at Administration on Aging. There was a sub-committee working around Medigap/Medicare as well.

We had an older Florida woman who went "undercover" shopping for Medigap insurance looking for fraud. In the past, volunteers would go look and check for fraud/real addressed (DME, Home Health, etc.) and do "investigative work," now the programs are set up differently.

Jon Lavin:
Our biggest early challenge for the program was obtaining information from the investigation of fraud from the Office of Inspector General, ACL, the U.S. Attorney, etc.

It was hard sustaining volunteer involvement when we could not show them real dollar evidence that the program worked.This is a program that offers a commanding message. I know the returns are still understated as to the importance of following that message!



I would like to personally thank Bill and Jon for speaking with Marina Silva and myself over the past few months. Without all their leadership we would not have a program that has been so successful for 25 years at AgeOptions and for the State of Illinois.

Please check back on November 30, 2020 for Part 2 of the of our 3 part series, What Does the Future Hold for The Illinois Senior Medicare Patrol Program?
Bill Benson, President of Health Benefits ABCs (HBABCs), offering health and aging policy, educational and strategic planning consulting services, has a long association with elder abuse, anti-health care fraud, and consumer protection efforts. Since 1998 Benson has served as the National Policy Advisor to the National Adult Protective Services Association, representing state and local APS programs. He played a key role on behalf of NAPSA in drafting and enacting the Elder Justice Act and other legislative initiatives related to elder abuse, neglect and exploitation. From 2006-2018 Benson worked with AoA’s national resource center for the states’ Senior Medicare Program (SMP) providing technical assistance to SMPs in their efforts to educate beneficiaries about fraud and abuse in the Medicare and Medicaid programs. As a former Acting Assistant Secretary for Aging at the U.S. Administration on Aging, he led AoA’s role in Operation Restore Trust, the U.S. Government’s national anti-Medicare and Medicaid fraud initiative, the establishment of the SMP program, and managed the Elder Rights program, among other responsibilities. Benson spent 8 years on Capitol Hill in senior roles and was heavily involved in the nursing home reform provisions of 1987 and the 1987 and 1992 reauthorizations of the Older Americans Act including the creation of the Elder Rights Title of the Act.  

Through his leadership as co-chair of the American Society on Aging’s Public Policy Committee, ASA adopted in 2018 elder abuse as one of its top two policy priorities. Benson co-founded and is president of the American Association for International Aging (IA2) which focuses on American Indian and Alaska Native (AIAN) elders. IA2 recently completed a federally funded project about health care providers’ experience in identifying elder abuse among AIAN patients. He is a former California State Long-Term Care Ombudsman and is a past president of the National Citizens Coalition for Nursing Home Reform (now Consumer Voice). Since 2000 Benson has hosted First Person, a series of conversations with survivors of the Holocaust before a live audience at the United States Holocaust Memorial Museum. 
Jonathan Lavin served from 1978 to 2018 as the Chief Executive Officer of AgeOptions – formerly the Suburban Cook County Area Agency on Aging, a non-profit corporation designated by the Illinois Department on Aging under the U. S. Older Americans Act and State Act on Aging.  

Over Mr. Lavin’s tenure as CEO, he oversaw organizational development in all facets of a large and complex organization, maintaining an understanding and interest in all programs and services directly provided and contracted out to community-based organizations (including non-profit, for-profit and governmental agencies).  During his tenure, he grew with the organization, establishing strategic planning, branding and identity, fund raising, human resources support, government relations, advocacy, technology infrastructure, corporate responsibility, financial integrity, and Board development skills and leadership, plus exposure to a variety of national organization’s structures and challenges as a Board Director.

Mr. Lavin lead advocacy efforts over his career including the establishment of the AgeOptions Advocacy Task Force which has identified policy issues effecting older persons in the region, educated all interested in aging policy and successfully advocated for legislation and administrative rules to improve care and benefits for older persons.
Have a safe and healthy Thanksgiving!

Travis Trumitch
travis.trumitch@ageoptions.org
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This project was supported, in part by grant number 90MPPG0036, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.
The Illinois SMP at AgeOptions partners with agencies across the state to empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education.

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