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.
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.”
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).
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.
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.
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!
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.
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?