ASCOG To Hold Senior Day

The Association of South Central Oklahoma Governments (ASCOG) will host the annual ASCOG Senior Day on Thursday, September 24 at the Stephens County Fair Grounds beginning at 9:00 a.m. until 2:00 p.m.  Individuals 60 or older who live in Caddo, Comanche, Cotton, Grady, Jefferson, McClain, Stephens and Tillman counties are invited to attend. 

There will be a FREE lunch, wellness checks, massages, educational seminars, door prizes, Bingo, a scavenger hunt, and much, much more. 

Attendees will be able to view the art, crafts, poetry, photography and quilts that have been submitted for judging.  The ASCOG Spelling Bee contest will be held and attendees will have the opportunity to watch the contest.

For information and contest entry forms, please contact Allison Everett, ASCOG Area Agency on Aging, 1-800-658-1466, ext. 223 or (580)736-7983 or email ever_al@ascog.org.  

CMS cutting-edge technology identifies & prevents $820 million in improper Medicare payments in first three years

The Fraud Prevention System is one part of the administration’s effort to protect the Medicare Trust Fund

 

After three years of operations, the Centers for Medicare & Medicaid Services (CMS) today reported that the agency’s advanced analytics system, called the Fraud Prevention System, identified or prevented $820 million in inappropriate payments in the program’s first three years. The Fraud Prevention System uses predictive analytics to identify troublesome billing patterns and outlier claims for action, similar to systems used by credit card companies.  The Fraud Prevention System identified or prevented $454 million in Calendar Year 2014 alone, a 10 to 1 return on investment.

"We are proving that in a modern health care system you can both fight fraud and avoid creating hassles for the vast majority of physicians who simply want to get paid for services rendered. The key is data," said CMS Acting Administrator Andy Slavitt. "Very few investments have a 10:1 return on taxpayer money."

The Fraud Prevention System was created in 2010 by the Small Business Jobs Act, and CMS has extensively used its tools, along with other new authorities made possible by the Affordable Care Act, to help protect Medicare Trust Funds and prevent fraudulent payments. For instance, last month Health & Human Services (HHS) and the Department of Justice announced the largest coordinated fraud takedown in history, resulting in charges against 243 individuals, including 46 doctors, nurses, and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings. Over the last five years, the administration’s efforts have resulted in more than $25 billion returned to the Medicare Trust Fund. 

The Fraud Prevention System helps to identify questionable billing patterns in real time and can review past patterns that may indicate fraud.  In one case, one of the system’s predictive models identified a questionable billing pattern at a provider for podiatry services that resulted in Medicare revoking the provider’s payments and referring the findings to law enforcement. The Fraud Prevention System also identified an ambulance provider for questionable trips allegedly made to a hospital. During the three years prior to the system alerting officials, the provider was paid more than $1.5 million for transporting more than 4,500 beneficiaries.  A review of medical records found significant instances of insufficient or lack of documentation. CMS also revoked the provider’s Medicare enrollment and referred the results to law enforcement. 

 “The third year results of the Fraud Prevention System demonstrate our commitment to high-yield prevention activities, and our progress in moving beyond the ‘pay and chase’ model,” said Dr. Shantanu Agrawal, CMS deputy administrator and director of the Center for Program Integrity. “We have learned a lot in the three years since the Fraud Prevention System began, and as we learn, we continue to become more sophisticated in detecting aberrant billing patterns and developing leads for investigations and action.”

In future years, CMS plans to expand the Fraud Prevention System and its algorithms to identify lower levels of non-compliant health care providers who would be better served by education or data transparency interventions.

For more information, please see the Report under “Guidance and Reports” at: http://www.cms.gov/About-CMS/Components/CPI/Center-for-program-integrity.html   

2015 ASCOG Senior Day Poetry Contest Deadline Fast Approaching

     The Association of South Central Oklahoma Governments (ASCOG) will host a Senior Health Fair Day on September 24, 2015, from 9:00 a.m. to 2:00 p.m. at the Stephens County Fair Grounds.  Individuals 60 or older who live in Caddo, Comanche, Cotton, Grady, Jefferson, McClain, Stephens and Tillman counties are eligible to compete in multiple contests featured during the event. There will be a Poetry contest, Spelling Bee Contest, a Photography Contest, and Art and Crafts contests. 

     The fast approaching deadline for the Poetry Contest is August 1.  All contestants must be 60 years of age or older and may submit up to three poems they personally authored.

     There will also be blood pressure checks, blood sugar checks and other wellness checks.  There will be door prizes throughout the day, Bingo, live entertainment, lunch provided by ASCOG, and much, much more.  Those who would like to set up a booth to sell arts, crafts, or other products will be permitted with a nominal booth registration fee.

     Certified Medicare Counselors will be available to answer your questions about Medicare.

     For registration, rules and entry forms, please contact Allison Everett at (580)736-7983.  

     Funding for this conference is provided in part by state and Older Americans Act funds from ASCOG AAA and DHS Aging Services.  It is the policy of ASCOG AAA to serve all individuals who are eligible for its programs without regard to race, national origin, ancestry, color, religion, sex, age or disability.

Healthcare inspections for nursing homes to be tougher under new OSHA rules

Nursing homes will face more scrutiny based on a new key hazard list from the Occupational Safety and Health Administration. The new hazards, specified in an OSHA memorandum, include musculoskeletal disorders related to resident handling, workplace violence, bloodborne pathogens, tuberculosis and slips, trips and falls. The hazards were addressed in OSHA's recent National Emphasis Program – Nursing and Residential Care Facilities, which involved collecting specific injury and illness data from 80,000 healthcare facilities.

“The goal of this policy is to significantly reduce overexposures to these hazards through a combination of enforcement, compliance assistance and outreach,” the OSHA memo reads. OSHA Assistant Secretary of Labor David Michaels, Ph.D., stressed the importance of creating safe working environments in hospitals and nursing homes in a statement.

“The most recent statistics tell us that almost half of all reported injuries in the healthcare industry were attributed to overexertion and related tasks. Nurses and nursing assistants each accounted for a substantial share of this total,” Michaels said. “There are feasible solutions for preventing these hazards and now is the time for employers to implement them.”

A long-term care ombudsman advocates for rights of persons in long-term care settings like nursing homes and assisted living facilities. Learn more about long-term care issues by contacting ASCOG long-term care ombudsman supervisors Ruben Sotelo, direct: 580-736-7975, sote_ru@ascog.org, or Darin Terry, direct: 580-736-7974, terr_da@ascog.org, toll free: 1-800-658-1466.

Community Expansion of Nutrition Assistance (CENA) Funding Announcement

The Association of South Central Oklahoma Governments (ASCOG) is accepting applications from eligible senior citizen centers for the Community Expansion of Nutrition Assistance (CENA).

CENA funds may be used for food, utilities, insurance, equipment, repairs and maintenance or other approved functions. This year, a special priority will be given to food and utilities.

CENA currently provides assistance to 43 independent senior centers in ASCOG’s eight-county area which includes Caddo, Comanche, Cotton, Grady, Jefferson, McClain, Stephens and Tillman counties.

Image Credit Bill Larkins public domain

To apply for a CENA grant, call Ken Jones at 580-736-7972. CENA applications are due by August 1.

POSITION AVAILABLE -

POSITION AVAILABLE

AREA AGENCY ON AGING INFORMATION AND ASSISTANCE SPECIALIST

The Association of South Central Oklahoma Governments is accepting resumes for an Area Agency on Aging Information and Assistance Specialist position in Duncan.  Experience in information and referral work required.  Acceptable equivalent I&R experience involves client-focused work in the field of human services that includes positions such as social work, discharge planning, consumer credit counseling, community health nursing, independent living skills instruction and school counseling, or employment in a homeless or domestic abuse shelter, food pantry, group home or other similar settings. Bachelors or higher degrees may be used to substitute for experience in accordance with AIRS Certification standards. Must have a valid Oklahoma driver’s license and be proficient in the operation of a computer using Microsoft Word, Excel, Access and Power Point.  Starting annual salary is $22,048.

Send resume to:  ASCOG, Attention Nancy English P. O. Box 1647, Duncan, OK. 73534. Resumes accepted through Thursday, July 23.  ASCOG is an Equal Opportunity Employer. 

Cameron to host OID Fraud Conference on July 14

Did you know you are the first line of defense against Medicare fraud, abuse, waste and Medical  identity theft?  When you receive those pre-screened offers for loans and insurance policies, did you know there is a way your identity can be stolen if you throw them in the trash before destroying them?  Do you receive those annoying robocalls from unknown callers?  How can you make them stop?

The Oklahoma Insurance Department is presenting an exciting and informative Senior Fraud Conference in Lawton on Tuesday, July 14 at Cameron University with a FREE breakfast, beginning at 8:00 am until 12:00 p.m.   Please call Vonn Saltzman, (580)736-7973 to register.  Learn how to protect, detect, and report.