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SMP: Volunteers Fighting Fraud

July 1, 2013 in Making a Difference

Senior Medicare Patrol (SMP) volunteers are a powerful weapon in the fight to prevent healthcare fraud and medical identity theft.

Recently, their importance was highlighted at Federal Trade Commission (FTC) forum Senior Identity Theft: A Problem in This Day and Age.

Barbara Dieker, Director of the Administration for Community Living Office of Elder Rights, addressed the panel and shared the added value SMP volunteers bring to the fight to prevent healthcare fraud and medical identity theft. She also gave advice on how seniors can protect their personal information.

  • Read “8 Ways to Fight Medical ID Theft” by Rick Kam president and co-founder of ID Experts. A quote from Ms. Dieker is at the end of the article.
  • View the video of the forum; Director Dieker’s portion begins at 1:04.
  • See Director Dieker’s comments, below:

Thanks so much. I’m Barbara Dieker. I’m actually within the Department of Health and Human Services, but I’m within the Administration on Aging, which is now the Administration for Community Living. And more of a comment and kind of an add to some of the things that you mentioned that would be good solutions.

I’m the director of the Office of Elder Rights there. One of my programs that I’m responsible for is a wonderful program called the Senior Medicare Patrol Program. Hopefully some of you have heard of that program and are familiar with it. And the sole purpose of this program is to empower seniors to prevent health care fraud. We basically—it’s a grantee program.

We have 54 grants, one in every state, Guam, Puerto Rico, Virgin Islands, and DC. And the purpose is to go out and recruit seniors to basically be trained in Medicare, Medicaid, and other health care programs, but primarily focused on Medicare. And how seniors then can prevent, identify, and report fraud, scams, ID theft, all the things we’re talking about.

So they’re thoroughly trained, these senior volunteers. And then they go into their local communities and they educate their peers on the very things that you were talking about—how to read your Medicare summary notice, how to prevent fraud by hanging up the phone when those telemarketers call, how to protect their personal information, and all the other things you’ve talked about.

And they go out to senior centers and they go out to health care affairs. And they go everywhere. And they work with providers, too, to educate them. And it’s a wonderful program. We have 5,000 senior volunteers across the country right now that are going out and working at the grassroots level to educate their peers and get them excited about how they can help save their Medicare. And many seniors view it that way, saving that money.

And to your point Rick, about redesigning the Medicare summary notice. That has recently been done–more readable. We were asked, as stakeholders, to help with that process. The Centers for Medicare and Medicaid Services has redesigned that Medicare summary notice to make it more readable and understandable by seniors. And it’s a big, big improvement.

And we thought it was so important because, obviously, that’s half of what we’re trying to do is tell people, how can you read that Medicare summary notice to identify potential fraud, things that were not billed to you?

We also just—and I won’t monopolize the rest of the time here. But the other thing that we do in addition to outreach and education of seniors is we assist individuals. And again, this is beneficiaries or family members, caregivers, whomever, when they have identified a potential issue. And of course, they don’t know right off whether it’s fraud, or an error, or whatever. But come back to us and we will assist you in either working it through and figuring out if it’s an error or fraud, or getting it into the right hands of the people who can investigate it.

We work hand in glove with the Office of the Inspector General, with CMS and others to make sure it gets into the right slot. So I just wanted to put in a plug for this program. If you’re not familiar with it and you want more information, just go to smpresource.org. And that’s our website that we have for lots and lots of information. And there’s a locator for your SMP in your specific state.

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