The Nevada Seniors Coalition is a diverse group of retirees from most all 50 states of the U.S.A., with relatives and friends in all 50 states. We are very appreciative of the Medicare benefits and are concerned that this most successful program in American history be preserved and protected by congress. We urge an emphasis on reduction of red tape, reduce administrative costs, eliminate fraud and abuse. We urge you to save programs that work and in particular to save the choice of provider, this is our only method of making hospitals and doctors listen to us. We suggest the following specifics:

● 1. Increase efforts to detect and eliminate fraud, provide incentives if needed. Estimated 15% cost savings.
● 2. Part A, hospital bill should show actual Medicare allowable and should be sent to patient at about time Medicare issues payment. This would eliminate many angry time consuming calls by senior patients, and save considerable administrative cost. Estimated 7% cost savings.
● 3. Part B, substantially reduce time doctor keeps patient under hospital observation but not admitted as a patient, a very costly practice to doctor and hospital bill, 8% cost savings.
● 4. Consider a Hospital Cost Advocate program as in Nevada NRS 679B. 500. This is a paid state employees program to ferret out hospital billing problems and is very effective. We suggest adding senior volunteers at no cost to increase the effectiveness of this program and further we suggest the program be expanded to cover doctors billings. Estimated 3% cost savings.
● 5. Medicare Information Counseling and Assistance (ICA) the program should be maintained and expanded by using thousands of capable Senior volunteers. Estimated 7% cost savings.
● 6. MILLIONS OF HOURS OF FREE QUALIFIED VOLUNTEER SENIORS time is available to save Medicare. Volunteer programs do work. Examples are RSVP, Medicare ICA, 55 Alive, Senior Net (computers for Seniors), National Park Volunteers and hundreds more.
● 7. Other considerations are paperwork reduction, slash bureaucracy, preventative medicine, and create volunteer programs such as, wellness, fitness and illness prevention. Estimated 8% cost savings.
● 8. Prescription Drugs should be added with a competitive pricing structure to save costs. See the program suggested below. People in HMO's and other prescription programs should pay close to wholesale cost.

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