SMP – Seniors Preventing Healthcare Fraud With Medicare and Medicaid Programs – Empowerment and Education
Posted Dec 29 2009 1:07pm
This group may not be as well known as other groups, but care and medications need to get to the people who need them, and fraud hurts everyone. Individuals can volunteer to serve and basically this is an outlet for when someone smells something “fishy” with care and products being provided.
In this example story below, a woman began receiving items that she had not asked for and Medicare was footing the bill for all of it. She contacted the agency and all the unwanted materials and devices were returned and an investigation began. The group has been around since 1995 and there is representation in each state with numbers and people to contact.
The SMP site offers a “toolkit” with questions and resources to help identify fraud and also helps train seniors on how to avoid identify theft. Partners on the website include many such as HHS, Office of the Inspector General, National Center on Elder Abuse, the FTC, CMS, and the US Department of Justice to name a few. The site is definitely worth a look to read up and get educated and secondly to get in touch if you feel fraud has been committed and have information. BD
“The SMP programs, formerly known as Senior Medicare Patrol programs, help Medicare and Medicaid beneficiaries avoid, detect, and prevent health care fraud. In doing so, they not only protect older persons, they also help preserve the integrity of the Medicare and Medicaid programs. Because this work often requires face-to-face contact to be most effective, SMPs nationwide recruit and teach nearly 5,000 volunteers every year to help in this effort. Most SMP volunteers are both retired and Medicare beneficiaries and thus well-positioned to assist their peers.
SMP staff and their highly trained volunteers conduct outreach to Medicare beneficiaries in their communities through group presentations, exhibiting at community events, answering calls to the SMP help lines and one-on-one counseling. 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. In some cases, SMPs do more than educate: When Medicare and Medicaid beneficiaries are unable to act on their own behalf to address these problems, the SMPs work with family caregivers and others to address the problems, and if necessary, make referrals to outside organizations who are able to intervene. “
MIAMI - The first box that arrived at Shirley Shupp's door was filled with braces to help with her arthritis. Then came a motorized scooter, just like the one the 69-year-old already owned. She hadn't asked for any of it — but Medicare was apparently footing the bill.
"There was just something that wasn't right about it," the Houston woman said.
So Shupp contacted her local Senior Medicare Patrol, which did its own research and then referred the matter to investigators. The equipment, worth thousands of dollars, was returned, the case was handed over to prosecutors and the perpetrators were charged with Medicare fraud.