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Resources for Older Adults

Medicare Social Security Fraud Hotlines

Medicare Social Security Fraud Hotlines

Both the Center for Medicare and Medicaid Services have cases of health fraud.

Medicare Phantom billing is the act of billing the Medicare program for medical tests, procedures or equipment that was either unnecessary or never provided. Medical care providers that perform this kind of fraud do so to exact more funds from the Medicare program for purposes other than providing vital care to beneficiaries.

Patient billing is the act of billing the Medicare program for procedures or services that were never rendered with the assistance of a Medicare beneficiary. The beneficiary will provide personal Medicare information claiming that the billed procedures did indeed take place to then receive a portion of the Medicare funds paid out.

Bill inflation is the act of using Medicare billing codes for more expensive procedures in the place of more basic procedures to receive more Medicare funds.

Medicare beneficiaries are asked by the CMS to report any form of Medicare fraud by calling, mailing or faxing letters, or emailing the Medicare fraud hotline through the Department of Health and Human Services with their concerns. Beneficiaries must provide information identifying themselves, dates of bills and procedures, reasons as to why Medicare should not have paid for the procedures or services and information identifying the medical provider. This way action can be taken to investigate the fraud claims submitted to the Medicare fraud hotline.

The Medicare fraud hotline also allows beneficiaries to report abuse suffered from health care providers.

Social Security fraud is often perpetrated through either theft of Social Security numbers, impersonating Social Security Administration employees or sending out fraudulent mailings posing as official letters from the Social Security Administration.

The theft of Social Security numbers enables the thief to have access to personal information of the Social Security beneficiary in addition to redirecting where Social Security benefits are directed. This is known commonly as identity theft.

By impersonating an employee of the SSA, the impostor hopes to gain access to personal information and Social Security information of the intended victim. In this way, the impostor can then steal Social Security benefits.

By sending fraudulent letters that pose as official mailings from the SSA, perpetrators again try to receive personal information relevant to Social Security benefits and then gain access to those funds.

The Social Security Administration has created a Social Security fraud hotline for beneficiaries to report cases of fraud by calling, mailing or faxing letters, or emailing the SSA directly. In addition to the Social Security fraud hotline, the SSA has a private investigatory force known as Continuing Disability Investigations or CDI. The CDI also coordinates with the Federal Bureau of Investigation and the Office of the Inspector General to investigate fraud reports submitted to the Social Security fraud hotline.

Both the Medicare fraud hotline and the Social Security fraud hotline were created with the assistance of the Office of the Inspector General.

Meals on Wheels Association of America

Meals on Wheels Association of America

The first meal delivered by an ancestor
program of Meals on Wheels in the United States was in January of 1954 in
Pennsylvania. This city funded program inspired other cities throughout the
country to develop a program where food is brought to needy senior citizens and
“shut-ins” who, without the program, would otherwise go hungry. After
Ohio and New York created similar programs to the one in Philadelphia, a
national program known as the Meals on Wheels Association of America (MOWAA)
was founded.

Although the MOWAA was created based
upon events in Philadelphia, Meals on Wheels began in England in the 1940s. As
a result of the Nazi Germany blitzkrieg and
the bombings of the RAF during World War II, the Women’s Volunteer Service
delivered cooked meals to the hungry in Hempstead, Hertfordshire. Later, in
1952, Australia adopted a similar Meals on Wheels program that was implemented
by a woman delivering food on her tricycle. The  Red Cross then stepped in
to support her efforts. Meals on Wheels was officially created in Australia in
1953 in South Melbourne.

The modern efforts of the MOWAA are
based on a Meals on Wheels program that was started in San Diego. This program
was a non-profit organization that coordinated the delivery of food to senior
citizens that need nutrition and human contact. National MOWAA operations are
conducted under the provisions of the “Four Pillars” which provide
for quality senior nutrition. These pillars ensure that meal providers serve
meals to the homebound, have food delivered on weekdays (with some providers
offering extra meals for weekends), facilities for food providers are in
adequate condition to function properly, and to respect the independence of the
homebound.

Other modern initiatives of MOWAA
include March for Meals, the Rural Initiative, Emergency Preparedness, and
WALOP.

        
March for Meals is an annual effort to raise funds and
advocate for those that suffer from senior hunger nationwide. It is held in the
month of March and was created to recruit new meal providers and provide
information about senior nutrition.

        
The Rural Initiative is MOWAA’s effort to extend service to
homebound senior citizens that live in remote, rural locations which challenge
meal providers due to cost and distance restraints.

        
Emergency Preparedness guidelines have been established by
the MOWAA in order for Senior Nutrition programs and meal providers to respond
to the needs of seniors in emergency situations.

        
WALOP, or We All Love Our Pets, is an initiative to provide
services for the pets of homebound senior citizens. This initiative was
introduced in 2006.

The MOWAA has also created the MOWAA
Foundation which performs studies about senior nutrition needs and the
nutrition needs of the disabled in the United States. A 2007 study entitled The Causes, Consequences and Future of
Senior Hunger in America
 provided statistics on those suffering from
senior hunger and those at risk.

The Meals on Wheels Association of
America is the oldest and most expansive program in the United States to meet
the needs of senior nutrition and the nutrition of people with disabilities
through a form of home health care

Alzheimers Association

Alzheimers Association

The Alzheimer’s Association was originally created as the Alzheimer’s Disease and Related Disorders Association in April of 1980. The goal of this association is to educate people about Alzheimer’s disease and eradicate it through funding research, Alzheimer’s care facilities
Alzheimer’s disease, or Senile Dementia of the Alzheimer Type, is a terminal form of brain degeneration. Alzheimer’s disease primarily affects persons of advanced age, 60 or older, however, there is an early onset form of this disease. Approximately 27 million people were diagnosed with Alzheimer’s globally in 2006. Discovered in the early 20th century, this disease is caused by a lack of proteins created in the brain tissue for the brain to function optimally.
The Alzheimer’s Association has raised funds numbering in the millions towards Alzheimer’s research and advocacy efforts. In the year of its inception, the Alzheimer’s Association’s initial investment to eradicating Alzheimer’s was $13 million. In succeeding years, through donations and federal grants, funds in increasing amounts have been directed to spreading Alzheimer’s information and developing preventative procedures to fight the disease. The association offers diverse array of services to educate and advocate for Alzheimer’s awareness through:
         A 24 hour helpline;
         Nationwide chapters that distribute Alzheimer’s information and create advocacy events;
         Online message boards for people to openly discuss their feelings, experiences, opinions and questions regarding Alzheimer’s disease;
         A nationwide medical service to respond to Alzheimer’s related emergencies, i.e. a person with Alzheimer’s wandering away from home;
         An open national library to specifically dedicated for educating people through Alzheimer’s information and research;
         Services to recommend programs and housing for those with Alzheimer’s;
         Publications that educate people about new advances in the fight against Alzheimer’s disease;
         and, National events and conferences to raise monetary donations for the research surrounding Alzheimer’s disease and spread Alzheimer’s information.
The three main events that the Alzheimer’s Association hosts on an expansive basis are the Alzheimer’s Association International Conference on Alzheimer’s Disease (ICAD), the Alzheimer’s Association Dementia Care Conference, and the Alzheimer’s Association Memory Walk. The ICAD hosts symposiums, workshops, and panel discussions that are attended by medical authorities, including researchers and physicians, in the field of dementia and Alzheimer’s. The Dementia Care Conference is hosted to provide continuing education opportunities for those that care for Alzheimer’s sufferers. The Memory Walk is a nationwide fundraiser that is hosted in all 50 of the United States. Volunteers are asked to donate money and support those afflicted with Alzheimer’s.
The Alzheimer’s Association has also created an initiative calling people to be “champions” for the sufferers of Alzheimer’s through the tiers of Voice, Open, Move, and Act.
         Voice: Champions are called to share their experiences with and opinions about Alzheimer’s.
         Open: Champions are called to educate themselves and others by “opening their eyes” and reading Alzheimer’s information.
         Move: Champions are called to volunteer time towards Alzheimer’s advocacy.
         Act: Champions are called to promote the fight against Alzheimer’s by writing letters to their local Congressional representatives.

American Association of Homes and Services for the Aging

American Association of Homes and Services for the Aging

The American Association of Homes and Services for the Aging, or AAHSA, was created in 1961 out a week long discussion about the future of long term care for aging Americans. The AAHSA helps families and elderly individuals globally by offering housing for seniors, medical care, nursing servicesretirement aid

The members that primarily make up the AAHSA are non-profit organizations that focus on providing care, housing for seniors, and other services to the elderly. The AAHSA focuses not only on the present condition of services provided for the aging, but on the future of elder care and housing in the United States and other nations. The efforts of the AAHSA are defined in their “Five Big Ideas”: Quality, Transitions, Talent, Finance, and Technology.

Quality

The AAHSA strives to provide high caliber results for its beneficiaries and their families by committing to offering clarity in its operations and a broad network of care.

Transitions

The AAHSA provides the opportunity for beneficiaries to access a variety of services as the needs of the beneficiary change. In this way, beneficiaries and their families can better plan for the future welfare of the beneficiary. An example of a transition that the AAHSA helps with is moving an elderly person from his or her domicile to specially designated housing for seniors.

 Talent

The AAHSA seeks out promising members to manage the care of the aging and provide ever-improving efforts to ensure that long term care and housing are available to the aging.

Finance

The AAHSA attempts to provide more efficient and sustainable financing methods for the care of the elderly. The AAHSA and its members work with families to properly finance the care of beneficiaries.

Technology

The AAHSA uses and promotes the development of better technology to care for the aging. It also invests in the creation of technological advancements that will enhance the quality and longevity of care.

The AAHSA, through its affiliates and members, has created a network of organizations that provide care for people of advanced age and housing for seniors in the United States and the global community.

The Center for Aging Services Technologies (CAST) develops and adopts new technology in the field of elder care for use by the AAHSA and its affiliates. Presently, the CAST is an international effort comprised of over 400 technology developers.

The Institute for the Future of Aging Services (IFAS) is an organization that researches policies and efforts independent of the AAHSA to find new, effective methods of care for the elderly.

The International Association of Homes and Services for the Aging (IAHSA) is the AAHSA’s effort to promote better care for the aging worldwide and provide access to the basic necessary care to the needy. The IAHSA establishes a stage for health care providers, sponsors, researchers and legislators to coordinate efforts for the care of the aging global community.

The Long Term Solution, as it is called, is the AAHSA’s plan for long term financing for care and housing for seniors. As the AAHSA defines it, “The goal is simple: to get as close to universal long-term care coverage as possible.”

Corporate Supporters are those that fund and provide services for the AAHSA and its beneficiaries. The supporters also share the vision of the AAHSA.

Centers for Medicare and Medicaid Services

Centers for Medicare and Medicaid Services

In July of 1965, the Johnson
Administration passed the Social Security Act which then created the Social
Security Administration, Medicare
Medicaid
CMS is based in Woodlawn, Maryland but
has 10 regional offices to coordinate the programs that CMS oversees. These
regional offices are located in Boston, New York, Philadelphia, Atlanta,
Chicago, Dallas, Kansas City, Denver, San Francisco, and Seattle. The CMS
offices in these major cities monitor the operations of the Medicare and
Medicaid programs in their designated jurisdictions. These regional offices are
also governed by a consortium located in four of the aforementioned major
cities. 

        
The Consortium for Medicare Health Plans Operations (CMHPO)
is located in New York. 

        
The Consortium for Financial Management and Fee for Service
Operations (CFMFFSO) is located in Kansas City. 

        
The Consortium for Medicaid and Children’s Health Operations
(CMCHO) is located in Chicago.

        
The Consortium for Quality Improvement and Survey &
Certificate Operations (CQISCO) is located in Dallas.


The five objectives of the Center for Medicare and Medicaid Services and its
regional offices, as noted in the CMS Strategic Plan 2008-2012, are as follows:

    
“Skilled, Committed, and Highly Motivated Workforce;

   
Affordable Health Care System;

    
High Value Health Care;

   
Confident, Informed Consumers;

    
and, Collaborative Partnerships.”

The Medicare program, as administered by
CMS, offers health insurance for eligible United States aged 65 and older as
well as the disabled. The program and its provisions are divided into four main
parts, Part A, Part B, Part C, and Part D. In order to receive Medicare
benefits, the applicant must have paid Medicare taxes and worked for a minimum
of 10 years in order to be eligible as well. If an employer offers Medicare as
a part of its benefits package, the employer shares the tax fees to be paid for
Medicare coverage. Part A of the Medicare program covers hospital insurance.
Part B covers medical care. Part C covers Medicare Advantage plans. Part D covers
prescription medication plans.

The Medicaid program is governed by the
Center for Medicare and Medicaid Services but is administered through local
state agencies. The program is a form of social welfare and is intended for
provide medical coverage for those with limited financial resources and special
needs. Being impoverished does not guarantee Medicaid eligibility as local CMS
offices and state Medicaid agencies review each application to ensure that
those that need care do receive it. Many states pay for a portion or all of the
cost of Medicaid benefits for certain applicants. The Center for Medicare and
Medicaid Services then uses a formula to match a percentage of the monies paid
out by state agencies toward Medicaid insurance.

Though both programs appear to be
similar, they differ in how they are funded and who they are intended to be
beneficiaries of provided medical coverage.