Illinois Senior Medicare Patrol (SMP) Program

Have you ever gotten a phone call from someone who said they were “from Medicare,” but to send you a new Medicare card, they need your Medicare number? Have you ever seen something listed on your Medicare Summary Notice that you didn’t receive? Have you had an insurance agent sign you up for an insurance plan without your permission?

If any of these have happened to you, you have experienced healthcare fraud. If you suspect fraud, please remember:

1. Healthcare fraud is not your fault. Fraud occurs in every city, in every state, every day. Scam artists will do anything to gain our trust, and even the most sensible consumers can get 'scammed.'
2. You CAN do something about it – you can report it to the Illinois SMP (Senior Medicare Patrol) Program!

Source: www.ageoptions.org

What is the SMP Program?

The SMP (Senior Medicare Patrol) Program empowers consumers to prevent healthcare fraud. Program staff and volunteers help people with Medicare and Medicaid to:

1. PROTECT themselves from Medicare & Medicaid fraud, waste, and abuse.
2. DETECT Medicare & Medicaid fraud, waste, and abuse.
3. REPORT Medicare & Medicaid fraud, waste, and abuse.

The Administration on Aging provides funding to SMP programs in all 50 states; Washington, D.C.; Puerto Rico; Guam; and the Virgin Islands. The Illinois SMP Program is located at AgeOptions, the Area Agency on Aging for Suburban Cook County. AgeOptions works with several other agencies to provide information about healthcare fraud in Illinois. These agencies are: Illinois Area Agencies on Aging, Catholic Charities, Senior Services Associates, the Coalition of Limited English Speaking Elderly, and the Illinois Network of Centers for Independent Living.

What is Healthcare Fraud?
Healthcare Fraud, waste, and abuse occur in all parts of the healthcare industry. Here are some examples:

• A home health agency bills Medicare for services that you never received.
• A medical equipment company bills Medicaid for a wheelchair that you didn’t need.
• A hospital purposely uses the wrong code for a lab test so they can get paid more
• A podiatrist visits a senior apartment building. He offers to trim everyone’s toenails, as long as they give him their Medicare numbers. He uses the residents’ Medicare numbers to bill Medicare for foot surgery.
• A doctor offers his patients money or gifts if they come to him for services.
• An insurance agent signs someone up for an insurance plan without her permission.
• An insurance agent lies to people about an insurance plan’s coverage to get them to join.

How does the SMP Program help stop Healthcare Fraud?

• To help consumers stop fraud, SMP staff and volunteers:
• Give presentations on healthcare fraud to groups.
• Provide information on healthcare fraud at community events.
• Help people report fraud when it occurs.