Senior Medicare Patrol programs, or SMPs, help Medicare and Medicaid beneficiaries prevent, detect and report health care fraud. They not only protect older persons, they also help preserve the integrity of the Medicare and Medicaid programs. Because this work often requires face-to-face contact to be most effective, SMPs nationwide rely on approximately 5,000 volunteers who are active each year to help in this effort. SMP of New Jersey at Jewish Family Services of Middlesex County is part of the national SMP network funded by the Administration for Community Living (ACL).
How, exactly, do SMPs fight fraud? SMP staff and volunteers work with individual beneficiaries to review Medicare Summary Notices for accuracy, make presentations to groups about how to avoid getting taken by scam artists, exhibit at community health fairs and more. Their primary goal is to teach Medicare beneficiaries how to protect their personal identity, identify and report errors on their health care bills and identify deceptive health care practices, such as illegal marketing, providing unnecessary or inappropriate services and charging for services that were never provided. In some cases, SMPs do more than educate: When Medicare and Medicaid beneficiaries are unable to act on their own behalf to address these problems, the SMPs work to address the problems, making referrals to the Centers for Medicare & Medicaid Services (CMS) and their anti-fraud contractors; the Office of Inspector General (OIG); state attorneys general offices; local law enforcement; State Health Insurance Assistance Programs (SHIP); state insurance divisions and other outside organizations that are able to intervene.
If you or someone you know is having trouble figuring out the Medicare maze or thinks they’ve been scammed or cheated, call NJ SMP Medicare Patrol – 732-777-1940 or email firstname.lastname@example.org. To read more about Medicare enrollment, scams and other information use the following links –
Informing the public is the first step in helping to prevent possible cases of Medicare fraud, waste, and abuse. Materials such as the tri-fold brochure and Personal Healthcare Journal are only a few ways of educating the public to the possible dangers. These and many other printed materials are available for FREE. Click on the links below to read some of the materials available or for more information. If you would like to receive any of these materials – contact AngelaE@jfsmiddlesex.org or call 732-777-1940 and ask for the Senior Medicare Patrol.
The Senior Medicare Patrol of New Jersey is actively expanding its partnerships in its effort to fight Medicare fraud, waste and abuse. In addition to being allies working toward our mutual goal of a safer and more secure healthcare system, our advisory committee members are envoys of their own causes and corporations. These additional perspectives combine to increase the effectiveness of our efforts and broaden the vision of the SMPNJ as a whole. For information about some of our associates, click on their logos below which will bring you to their sites.
Do You Worry About Your Elderly Parents?
SMP and Jewish Family Services do also. The following tips will help you protect your loved ones from being a victim of a Medicare scam.
TIP 1: DO NOT give out your Medicare # to anyone you do not trust. Safeguard your number as you would your bank account or credit card numbers.
TIP 2: Hang up the phone or shut the door if you are contacted by someone claiming to be a Medicare representative. Guess what… Medicare will not call you or make a home visit. “It’s shrewd to be rude.”
TIP 3: Shred your Medicare, health care, and other important documents before throwing them away. Take advantage of free community shredding events.
TIP 4: Be sure to read your Medicare Summary Notice even though it says “This is Not a Bill.” Be on the lookout for services which were not provided, services that were billed twice, or for services not ordered by your doctor. If you see something that doesn’t look right, call your doctor’s billing office right away.
TIP 5: Use a calendar or health care journal to record all of your doctor visits, medical tests and procedures. Compare your Medicare Summary Notice with your calendar or journal. If you see something that does not look right, call your doctor’s billing office right away.
TIP 6: Count your prescription pills. If you are short the prescribed number, complain to your pharmacist. Don’t be afraid to speak up.
TIP 7: Have a friend or neighbor pick up your mail from your mailbox if you are away for more than one day.
TIP 8: Are you aware that the rules for durable medical equipment were changed effective July 1, 2013? Medicare beneficiaries MUST obtain their equipment & supplies from a contracted Medicare provider in order to be covered. Check www.medicare.gov for a list of contracted suppliers in your area or call 1-800-Medicare.
TIP 9: Do you know that Medicare Part D prescription drug plans change annually? Your plan premium may change and your prescriptions may no longer be covered. You will need to find a plan to cover your prescriptions. Protect yourself by reviewing your existing Part D plan for changes. You can change your plan on during open enrollment each year. Open enrollment dates are between October 15 and December 7. December 7 is the last day of each year that you may select a new plan. Need help? Call – 1-800-Medicare or your State Health Insurance Assistance Program at 1-800-792-8820.
TIP 10: Beware… if you have Medicare, don’t let someone sell you a new Marketplace plan which is for people without health insurance. Medicare is your health insurance.
TIP 11: If you think you’re the victim of health care fraud, call the Senior Medicare Patrol of NJ at 1-877-SMP-4359. It’s a toll-free number and we’re a federally funded program that works to educate and empower seniors to prevent health care fraud. There is no charge for our services.
The SMP program provides an opportunity for volunteers to step up and make an impact in the fight against fraud. SMP will match volunteers with a task that fits their time, interest, and location. Contact the volunteer coordinator for details.
Senior Medicare Patrol (SMP) Project
Jewish Family Services of Middlesex County
32 Ford Avenue, Second Floor, Milltown, NJ 08850
Tel: 732-777-1940 Fax: 732-777-1889 Hotline: 877-SMP-4359
Charles Clarkson, Esq. – Project Director
Michelle Beley-Bianco – Volunteer Coordinator
Angela Ellerbe – Outreach Specialist