Senior Medicare Patrol
On April 2, 2022, the Senior Medicare Patrol was highlighted on the Today Show. The Fleecing of America: Telemedicine Fraud Surges Amid Pandemic
What is the Senior Medicare Patrol?
What is Health Care Fraud?
What Can I Do?
Guides from the Senior Medicare Patrol Program
Volunteer with the Senior Medicare Patrol
- One-on-one counseling and assistance to people on Medicare. Counselors are available to help beneficiaries read their Medicare summary notices, review their cases and understand billing and other paperwork. In suspicious cases, SMP can help beneficiaries to report fraud to the proper authorities.
Presentations to beneficiaries, caregivers and other concerned citizens. Presentations cover the types of fraud and abuse that occur and the steps that seniors can take to protect themselves. To schedule a free speaker, call your local Area Agency on Aging at 1-800-994-9422 and ask to speak with someone from the Senior Medicare Patrol.
- Billing for services never performed or medical equipment or supplies not ordered.
- Billing for services or equipment that are different from what was provided or was returned.
- DOUBLE BILLING - charging more than once for the same service.
- UPCODING - billing for a more expensive or covered item when a less expensive, non-covered item was provided.
- UNBUNDLING - billing related services separately to charge a higher amount than if they are combined and billed as one service or group of services.
- Falsely claiming that services are medically necessary when they are not.
- Using another person’s Medicare card to get medical care, supplies, or equipment.
- Soliciting, offering or receiving bribes, rebates or kickbacks. (A kickback is an arrangement between two parties which involves an offer to pay for Medicare business.)
What Can I Do?
Prevent, Detect and Report
- The equipment, service or test is free.
- The provider knows how to get Medicare to pay for items or services, even if they are not usually covered.
- They claim to represent Medicare or maintains they have been endorsed by the federal government.
- Use telemarketing and door-to-door selling as marketing tool.
- Advertise "free" consultations to people on Medicare or offer “free” testing or screening in exchange for your Medicare card number, just for their records.
- Use pressure or scare tactics to sell you high-priced medical services or diagnostic tests.
- Charge co-payments on clinical laboratory tests, and on Medicare covered preventive services such as PAP smears, prostate specific antigen (PSA) tests, or flu and pneumonia shots.
- Call the healthcare provider or supplier first to question the charge. If it was a mistake, ask them to correct it.
- If the provider or supplier can't answer the question, call the company that paid the bill. Their contact information can be found on your Medicare Summary Notice or Explanation of Benefits.
- Call the Connecticut SMP at 1-800-994-9422 if the issue cannot be resolved or you suspect fraud or abuse. The Senior Medicare Patrol can assist you and can help refer cases to the proper authorities when necessary.
- Actions You Can Take To Protect Your Personal Information
- Don't Be A Victim of Healthcare Fraud, Scams or Identity Theft
- Don't Be A Victim of Fraud, Abuse or Scams: Tips for Medicare Consumers
- Guidelines for Shredding and Saving Personal Documents
- TRIAD Guidebook
By volunteering with the Senior Medicare Patrol, you can become an integral member of the growing effort to educate the community about Medicare health care fraud, errors and abuse, as well has empower people with Medicare to recognize suspected fraud, protect themselves from it, and report it.
Volunteers are educated regularly on issues pertaining to Medicare and health care fraud and scams. You will have continued support from SMP staff and other volunteers. Volunteer opportunities include:
- Community Events & Health Fairs: Attend community events and help educate the public about Medicare fraud.
- Information distributor: This role involves transporting and disseminating materials to sites and events.
- Office Support: Participate in office projects, distribute SMP materials to senior centers, assemble supplies for community events & seek out volunteer opportunities around Connecticut for other volunteers.
- One-On-One Counseling: Meet with beneficiaries to help them understand Medicare Summary Notices and other healthcare documentation.
- Presentations: Deliver prepared presentations about Medicare fraud.
- Promotions: Write articles for newsletters and create other media messages.
SMP Volunteer Coordinator will meet with each potential volunteer to discuss their goals and explain how SMP can match their interests and talents to help provide a meaningful volunteer experience. Volunteers are screened depending on the nature of work they perform with Medicare Beneficiaries. In many cases a background check is performed.
A SMP Orientation and Foundations training is provided to all Senior Medicare Patrol Volunteers. Depending on your interest, additional training is provided so you can feel supported in your volunteer role.
Upcoming Foundations Training
There is no training currently scheduled
- State of Connecticut Attorney General’s Office.
- Federal Trade Commission (FTC) - Identity Theft Site : Contains Q&A and resources for victims.
- Fraud.Org: Contains information on fighting fraud as well as telemarketing fraud and information on how to get your name off mailing lists.
- Sign up for the National Do Not Call Registry.
- Consumer Law Project for Elders.
- Information about New Medicare Cards.
- National Senior Medicare Patrol Performance and Statistics.
- Latest Information on Scams and Reported Fraud