Senior Medicare Patrol
What is the Senior Medicare Patrol?
Senior Medicare Patrol programs, or SMPs, help Medicare and Medicaid beneficiaries prevent, detect, and report health care fraud. They not only protect beneficiaries, they also help preserve the integrity of the Medicare and Medicaid programs.
The North Dakota Senior Medicare Patrol( ND SMP) program is part of a national network implemented by the Administration for Community Living, under the U. S. Department of Health and Human Services, which oversees aspects of the Medicare and Medicaid programs. ND SMP is a statewide grant funded project through North Dakota Center for Persons with Disabilities( NDCPD) located on the campus of Minot State University. The SMP mission is to provide Medicare and Medicaid beneficiaries with outreach and education, which revolves around the messages‘ prevent, detect, and report.’
In some cases, ND SMP does more than educate: When Medicare and Medicaid beneficiaries are unable to act on their own behalf to address these problems, SMP works to address the problems, making referrals to the Centers for Medicare & Medicaid Services( CMS) and their antifraud contractors; the Office of Inspector General( OIG); state attorney general’ s office; local law enforcement; State Health Insurance Counseling Program( SHIC); state insurance divisions; and other outside organizations that are able to intervene.
What are examples of fraud and waste seen by SMPs?
• Equipment or insurance plan providers tricking senior center participants into giving up their personal information( including Medicare numbers) on“ signin” sheets
• Medicare Summary Notices showing billing for services or supplies that were never provided
• Equipment suppliers providing expensive“ scooter” wheelchairs or back and knee braces not ordered by a physician or needed by the beneficiary
• Luring beneficiaries into providing their Medicare numbers for“ free” services, then billing Medicare
• Kickbacks – paying beneficiaries to receive service from a particular provider or company
Where can I learn more?
ND SMP is available to assist you with the information you need to PROTECT yourself from Medicaid errors, fraud, and abuse; DETECT potential errors, fraud, and abuse; and REPORT your concerns. For assistance, call the ND SMP program at 1-800-233-1737 or 701-858-3580.
Supported by grant number 90MP0217 from the Administration for Community Living, Dept. of Health & Human Services.
Health care fraud is not a victimless crime. Efforts to crack down on fraud will not only help beneficiaries, but will ultimately maintain the integrity of the Medicare / Medicaid system to ensure solvency for next generations.
How, exactly, do SMPs fight fraud?
SMP staff and volunteers work with beneficiaries to review Medicare Summary Notices for accuracy, make presentations to groups on ways avoid scams and fraud, exhibit at community health fairs, and more.
Their primary goal is to teach Medicare beneficiaries how to protect their personal identity, identify and report errors on their health care bills, and identify deceptive health care practices, such as illegal marketing, providing unnecessary or inappropriate services, and charging for services that were never provided.
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