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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