Kansas Senior Medicare Patrol (SMP) empowers and assists Medicare beneficiaries, their families, and caregiversto prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education. There are 54 SMP projects nationwide.
SMPs focus on three main areas:
Outreach and Education. SMPs give presentations to groups, exhibit at events, and work one-on-one with Medicare beneficiaries to prevent, detect, and report potential Medicare fraud.
Volunteerism. The SMP program is a volunteer-based program. Protecting older persons’ health, finances, and medical identity while saving precious Medicare dollars is a cause that attracts civic-minded people to volunteer for the SMP program.
Beneficiary Complaints. When Medicare beneficiaries, caregivers, and family members bring their complaints to the SMP, the SMP makes a determination about whether or not fraud, errors, or abuse is suspected. When fraud or abuse is suspected, they make referrals to the appropriate state and federal agencies for further investigation.
SMPs are grant-funded projects of the federal U.S. Department of Health and Human Services (HHS), U.S. Administration for Community Living (ACL).
Fraud Alerts and Information
Medicare fraud assumes criminal intent. The Centers for Medicare and Medicaid Services (CMS) defines fraud as “the intentional deception or misrepresentation that the individual knows to be false or does not believe to be true,” and that is made “knowing that the deception could result in some unauthorized benefit to himself or herself or some other person.
The SMP Resource Center has produced a tip sheet warning about the most common Medicare fraud schemes. Please feel free to print this document with all the tip sheets:Fraud Schemes Fact Sheets
Report Suspected Fraud in Kansas
If you suspect Medicare fraud, errors, or abuse, address it immediately by taking these steps:
Rule out error: If you have questions about information on your or your loved one's Medicare Summary Notice (MSN) or Explanation of Benefits (EOB), call the provider or plan and ask for an explanation.
Get help from your SMP: If you are not comfortable calling the provider or plan or if you are not satisfied with their response, your local SMP can help you:
Identify and report fraud schemes and deceptive health care practices, such as illegal marketing or billing for services that were never provided.
Refer complaints of potential fraud and abuse to the appropriate entity, who can intervene. For example:
HHS Office of Inspector General (OIG)
Centers for Medicare & Medicaid Services (CMS)
State attorneys general
Local law enforcement
State departments of insurance
State Medicaid Fraud Control Units (MFCU)
Get help from other sources:
Contact local law enforcement
Call 1-800-Medicare
Report directly to the OIG Hotline: 1-800-HHS-TIPS (800-447-8477)
When reporting fraud, have the following information available:
Your name as listed on your Medicare or Medicaid card
Medicare number
Name of the provider
Date of service
Description of the concern or problem
Call Kansas SMP at 800-860-5260
Become a Volunteer
The SMP program offers volunteers an opportunity to make an important difference in their communities. Volunteers take pride in working to ensure that the Medicare program will be protected for future generations.
What SMP Volunteers Do
SMP projects match a volunteer’s skills and interests to the needs of the program. As a result, SMP volunteers may serve Medicare beneficiaries, their families, and caregivers in many creative ways. However, there are six types of activities most commonly conducted by SMP volunteers nationwide:
Assist with administration: Help with work such as copying, filing, data entry, and placing outbound phone calls in support of SMP activity
Distribute information: Help with transporting and disseminating SMP information materials to sites and events; may include presenting prepared copy or performing scripted activities for small groups
Staff exhibits: Help by staffing information booths or exhibits at events such as health fairs; also may provide general information about SMP to the public and answer basic questions
Make group presentations: Help by giving presentations on SMP topics to small and large groups; may interact with the audience by answering questions and through discussion
Counsel: Help by having direct conversations with beneficiaries about their individual situations; may include review of personal information such as Medicare Summary Notices, billing statements, and other related financial and health documents
Manage interactions and referrals: Help beneficiaries who are reporting specific instances of health care fraud, errors, and abuse; may refer suspected fraud and abuse to the appropriate authorities
Interested? Call 800-860-5260 or download the volunteer brochure below.
This project was supported, in part, by grant number 90MP0087 from the U. S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, represent official Administration for Community Living policy.