Senior Medicare Patrol

Our Purpose

In 2010, we partnered with the Utah Department of Aging Senior Medicare Patrol (SMP) program in Salt Lake City. Our purpose is to focus on prevention, with a mission of empowering Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud and identity theft, errors, and abuse through outreach and education.

The SMP is a national program for people with Medicare of all ages. SMP is administered by the Administration for Community Living. To learn more, volunteer or to locate your local Senior Medicare Patrol please call 1-877-808-2468 or visit https://www.smpresource.org


Do you think you are a victim of Medicare fraud or abuse?
If you need help contacting your local SMP, fill out the form here: https://smpresource.news/Contact

Medicare Fraud Prevention Week focuses on the actions everyone can take to prevent Medicare fraud, errors, and abuse. Learn how you can protect yourself and your loved ones from Medicare fraud by joining us on June 5th to kick off celebrating this week!

June 2022 marks the 25th anniversary of the Senior Medicare Patrol (SMP) Program and to commemorate this event the SMP is creating a national week focused on Medicare fraud Prevention.

Why is This Week Important?

Medicare loses an estimated $60 billion each year due to fraud, errors, and abuse. Every day, issues related to these concerning matters affect people across the country, often costing them money, time, and well-being. Medicare-related errors contribute to this annual loss even though errors can be honest health care billing mistakes. However, a pattern of errors committed by a physician or provider could be considered a red flag of potential fraud or abuse if not corrected.

When people steal from Medicare, it hurts us all and is big business for criminals. Some common examples of fraud or abuse could include:

  • Charging for services or supplies that were not provided

  • Misrepresenting a diagnosis, a person’s identity, the service provided, or other facts to justify payment

  • Prescribing or providing excessive or unnecessary tests and services

Falling prey to consumer scams or health care fraud may mean that your Medicare number has been “compromised” as a result of medical identity theft. Theft from Medicare leaves less available funds for those needing services now as well as those needing Medicare in the future.

How to Take Part in the Week

The most effective way to stop fraud from occurring is to prevent it in the first place. Educating yourself and your loved ones on how to prevent Medicare fraud, errors, and abuse is the best place to start.

If you are a Medicare beneficiary, kick off the week on 6/5 by learning how to read your Medicare statements! Read your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) in the paper form that is mailed to you or go online to Medicare.gov and review claims digitally.

Remember the three steps from the SMP: Prevent, Detect, Report!

  • Prevent: Learn how to read your MSN by watching this video, How to Read Your Medicare Summary Notice (MSN). You can also call your SMP or go to their website to learn how to best protect yourself and your loved ones from health care fraud, errors, or abuse. Find your SMP by using the state locator.

  • Detect: When reviewing your MSN or EOB, look for services, products, or equipment you didn’t receive, double charges, or items your doctor didn’t order.

    • Request and use a My Health Care Tracker from your SMP to compare appointment information you recorded with what is printed in your MSNs and/or EOBs.

    • If you find items of concern, call the doctor or company in question and ask them about potential mistakes. Call your insurance company if you still have questions.

  • Report: Call or email your local SMP if you believe that you have experienced health care fraud, errors, or abuse or if you would like to request a My Health Care Tracker.

Caregivers, help by educating yourself and your client or loved one on how to prevent and detect health care fraud, errors, and abuse. Be on the lookout for items such as durable medical equipment (like boxes of knee braces) lying around the house that may have been shipped to the beneficiary without their or their doctor’s approval. Remind your client or loved one to never give out their Medicare number or other personal information over the phone.

Families, help by talking to your loved ones about protecting their Medicare number just as they would a credit card number. Encourage them to check their Medicare statements for fraud, errors, or abuse and never give out their Medicare number over the phone for any reason. Help your loved ones create a Medicare.gov account to access their Medicare claims online or remind them to open and review their statements when they come in the mail every three months. You can also register their phone number on “do not call” lists and go to optoutprescreen.com to opt out of mailings.

Partners and professionals, help by sharing SMP information on social media, referring clients and consumers to the SMP, and inviting the SMP to speak during a shared event. Identify ways to collaborate on mission-related topics and information.

Health care providers, help by talking to patients about health care-related scams such as those related to durable medical equipment and genetic testing schemes. Remind them that products and services should only be ordered by physicians they regularly see. Needed medical items should never be ordered through TV ads or unsolicited calls.

Lastly, as a community, help by looking out for your older neighbors. When in public, be aware of older individuals purchasing gift cards in large amounts. If you overhear someone talking about Medicare, don’t be afraid to offer information about SMP and SHIP. Encourage those you know to talk to a trusted source about their Medicare questions and tell your neighbors about the most recent Medicare scams. Consider volunteering with your local SMP!

For more information visit https://www.smpresource.org/Medicare-Fraud-Prevention-Week.aspx.

FYI ... www.smpresource.org

March 10, 2022 was national #SlamTheScam day! However, you can still join the #SeniorMedicarePatrol along with the Federal Trade Commission , HHS Office of Inspector General , Social Security Administration , and other government organizations by slamming the scam! Look at all of these different organizations and different ways you can protect yourself and your loved ones from scams. #NCPW2022


SMP Consumer Fraud Alert

Top 10 Financial Scams Targeting Seniors

Reference article at www.smpresource.org

May 8, 2022

Key Takeaways

  • Financial scams targeting the elderly can be devastating, leaving older adults in a vulnerable position and without time to recoup their losses.

  • Older adults lose an estimated $3 billion each year to financial scams.

  • Learn how to identify and stop the top 10 financial scams targeting seniors.


Financial scams targeting seniors are prevalent and costly. The FBI estimates that seniors lose more than $3 billion each year to fraudsters. Scammers go after seniors because they believe older adults have a significant amount of money sitting in their accounts.

1. Government impostor scams

Government impostors call unsuspecting victims and pretend to be from the Internal Revenue Service (IRS), Social Security Administration, or Medicare. They may say you have unpaid taxes and threaten arrest or deportation if you don’t pay up immediately. Or they may say your Social Security or Medicare benefits are in danger of being cut off if you don’t provide personal identifying information (that can then be used to commit fraud). Government impersonators often “spoof” the actual phone numbers of the government agency, or call from the same zip code (202 for Washington, DC).

2. The grandparent scam

The grandparent scam is so simple and so devious because it uses one of older adults’ most reliable assets, their hearts. Scammers will place a call to an older person and say something along the lines of: “Hi Grandma, do you know who this is?” When the unsuspecting grandparent guesses the name of the grandchild the scammer most sounds like, the scammer has established a fake identity without having done any background research. Once “in,” the fake grandchild will ask for money to solve some unexpected financial problem (overdue rent, car repairs, jail bond) and will beg the grandparent not to tell anyone. Because scammers ask to be paid via gift cards or money transfer, which don’t always require identification to collect, the senior may have no way of seeing that money ever again.

3. Medicare/health insurance scams

Every U.S. citizen or permanent resident over age 65 qualifies for Medicare, so there is rarely any need for a scam artist to research what private health insurance company older people have in order to scam them out of some money. In these types of scams, perpetrators may pose as a Medicare representative to get older people to give them their personal information, or they will provide bogus services for elderly people at makeshift mobile clinics, then bill Medicare and pocket the money. Medicare scams often follow the latest trends in medical research, such as genetic testing fraud and COVID-19 vaccines.

4. Computer tech support scams

Computer technical support scams prey on people’s lack of knowledge about computers and cybersecurity. A pop-up message or blank screen usually appears on a computer or phone, telling you that your device is compromised and needs fixing. When you call the support number for help, the scammer may either request remote access to your computer and/or that you pay a fee to have it repaired. The Federal Trade Commission (FTC) found that seniors who fell for this scam lost an average of $500 each to computer tech support scams in 2018.

5. Sweepstakes & lottery scams

This simple scam is one that many are familiar with, and it capitalizes on the notion that “there’s no such thing as a free lunch.” Here, scammers inform their mark that they have won a lottery or sweepstakes of some kind and need to make some sort of payment to unlock the supposed prize. Often, seniors will be sent a check that they can deposit in their bank account, knowing that while it shows up in their account immediately, it will take a few days before the (fake) check is rejected. During that time, the criminals will quickly collect money for supposed fees or taxes on the prize, which they pocket while the victim has the “prize money” removed from his or her account as soon as the check bounces. Unlike some of the other scams noted here, lottery and sweepstakes scammers can sometimes collect thousands of dollars from their unsuspecting victims.

6. Robocalls/phone scams

Robocalls take advantage of sophisticated phone technology to dial large numbers of households from anywhere in the world. Robocallers use a variety of tactics to cheat their victims. Some may claim that a warranty is expiring on their car/electronic product and payment is needed to renew it. One popular robocall is the “Can you hear me?” call, where when the senior says yes, the scammer hangs up after recording their voice, thus obtaining a voice signature to authorize unwanted charges on items like stolen credit cards.

7. Romance scams

As more people use the Internet for dating, con artists see an opportunity to find their next victim. Romance scammers create elaborate fake profiles, often on social media, and exploit seniors’ loneliness for money. In some cases, romance scammers may (or pretend to) be overseas, and request money to pay for visas, medical emergencies, and travel expenses to come visit the U.S. Because they drag on for a long time, romance scammers can get a lot of money from a senior—the FTC found that in 2019 alone, seniors lost nearly $84 million to romance scams.

8. Internet and email fraud

While using the Internet is a great skill at any age, the slower speed of adoption among some older people makes them easier targets for automated Internet scams that are ubiquitous on the web and email programs. Pop-up browser windows simulating virus-scanning software will fool victims into either downloading a fake anti-virus program (at a substantial cost) or an actual virus that will open up whatever information is on the user’s computer to scammers. Their unfamiliarity with the less visible aspects of browsing the web (firewalls and built-in virus protection, for example) make seniors especially susceptible to such traps.

Phishing emails and text messages may look like they’re from a company you know or trust. They may look like they’re from a bank, a credit card company, or an online store. Phishing emails request your personal information, such as a log-in or Social Security number to verify your account, or ask that you update your credit card payment. Then they use that information to steal your personal and financial information.

9. Elder financial abuse

Unlike many of the other scams, elder financial abuse is carried out by someone a senior knows. This can be a family member, friend, power of attorney, or caregiver. These trusted individuals try and gain control of a senior’s money, assets, and credit. They also may withhold needed care in order to retain control over the person and their assets. Seniors who have a disability or cognitive impairment (such as dementia) may be at particular risk.

10. Charity scams

Charity scams rely on seniors’ goodwill to pocket money they claim they’re raising for a good cause. Some scammers may use a name similar to a legitimate charity. They often capitalize on current events, such as natural disasters, and may set up a fundraising page on a crowdsourcing site, which don’t always have to means to investigate fraud. Charity scammers may insist you donate immediately, sometimes with a payment method that should be a red flag—e.g., gift cards or money transfer.

If you suspect you’ve been the victim of a scam…

Don’t be afraid or embarrassed to talk about it with someone you trust. You are not alone, and there are people who can help. Doing nothing could only make it worse. Keep handy the phone numbers and resources you can turn to, including the local police, your bank (if money has been taken from your accounts), and Adult Protective Services. To obtain the contact information for Adult Protective Services in your area, call the Eldercare Locator, a government sponsored national resource line, at: 1-800-677-1116, or visit their website at: https://eldercare.acl.gov.

You can also report scams online to the Federal Trade Commission, https://www.ncoa.org/article/top-10-financial-scams-targeting-seniors or https://www.smpresource.org/

FYI ... www.SMPResource.org

April 13, 2022

While not answering numbers you don't know is the best choice, scammers are tricky and you might answer thinking it is someone else. When you get these calls, just hang up. This is the safest way to avoid giving out personal or financial information.

Couple Targeted in Cardiac DNA Testing Scam

FYI ... www.SMPResource.org March 8, 2022

Minutes after a package with genetic testing was dropped off at their doorstep, Teegee and Alan Levy received a call from an unknown number. It was from a man at the lab and he sounded professional to them. They thought the tests were legitimate until weeks later, when they called their doctor to ask about the results. Their doctor didn’t know what they were talking about. View a story from TMJ4 and read a consumer alert from the Senior Medicare Patrol.

FYI ... www.SMPResource.org

April 14, 2022

  • "When a beneficiary elects hospice care, the hospice is responsible for providing all services related to the beneficiary’s terminal illness and related conditions. When a hospice does not comply with Medicare requirements, there can be significant consequences for the beneficiary. Although these cases do not represent the majority of hospice beneficiaries or the majority of hospice providers, any instance of harm must be taken seriously," from HHS Office of Inspector General.

  • To learn more about hospice fraud, errors, or abuse, visit https://smpresource.news/hospicefraud.



BE ON THE LOOKOUT ... share this information with your friends and family!!!

If someone calls and talks about any of these items below, hang up. If you have given out your Medicare number over the phone, contact your local #SeniorMedicarePatrol. Call 877-808-2468 or visit the state locator at smpresource.org.

FYI ... www.SMPResource.org

Do you know someone who has Medicare but doesn't have access to the internet? Here is a printable handout of the most common fraud schemes to be aware of that you can offer a neighbor or loved one who may not have access to the internet.

Each topic has details on the scheme, things to watch out for, and how to report it. Please share this link and resource with everyone you know on Medicare: https://smpresource.news/FraudSchemesPrintableHandout


Dollars Lost to Fraud

Medicare fraud is big business for criminals. Medicare loses billions of dollars each year due to fraud, errors, and abuse. Estimates place these losses at approximately $60 billion annually, though the exact figure is impossible to measure.

Medicare fraud hurts us all. When thieves steal from Medicare, there is less money for the health care you really need. You pay for things you might never get. You can get hurt when you get tests, medicine, or care you don’t need. Doctors, pharmacies, and medical suppliers can make mistakes and bad choices. Sometimes they straight-up steal from Medicare. Medicare is trying to crack down.

How You Can Help

Be the first line of defense in protecting your Medicare benefits.

  • Treat your Medicare card like a credit card. Your Medicare number can be valuable to thieves who want to steal your medical identity or bill Medicare without even seeing you.

  • Don’t take advice or offers of medical services from people you don’t know who call, come to your house, or approach you in public.

  • Read your Medicare Summary Notice or Explanation of Benefits. Look for services or equipment you didn’t receive, double charges, or things your doctor didn’t order.

  • Ask questions and report problems. Call the doctor or company and ask them about mistakes. Call the insurance company if you still have questions. Get help from your local SMP.

  • Volunteer. No one cares more about keeping criminals out of Medicare than the people who need it. Become a part of your local SMP program. Help protect your friends and neighbors.

How Your Senior Medicare Patrol (SMP) Can Help

Your local SMP is ready to provide you with the information you need to PROTECT yourself from Medicare fraud, errors, and abuse; DETECT potential fraud, errors, and abuse; and REPORT your concerns. SMPs and their trained volunteers help educate and empower Medicare beneficiaries in the fight against health care fraud.

Your SMP can help you with your questions, concerns, or complaints about potential fraud and abuse issues. It also can provide information and educational presentations. To locate your state Senior Medicare Patrol (SMP) use the SMP State Locator or call 1-877-808-2468.

For a printable resource, see the Medicare Fraud by the Numbers Fact Sheet.


NEWS:

Recent proposals in Congress would drastically impact Medicare beneficiaries by linking U.S. health care costs to foreign countries and encouraging government price controls. We ask Sen. Mike Lee, Sen. Mitt Romney, Rep. Rob Bishop, Rep. Chris Stewart, Rep. John Curtis and Rep. Ben McAdams to actively oppose any policies that would be harmful to Utah’s nearly 390,000 Medicare beneficiaries. Utah's representatives should support patient-centered reforms that cap out-of-pocket drug spending in Medicare Part D and ensure pharmaceutical discounts negotiated by insurance companies are shared with patients at the pharmacy counter.


SMP Newsletter

JUNE 2022