Earlier this month, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published its report on the performance of the Senior Medicare Patrol (SMP) program in 2023. The SMP projects in all 50 states, the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands receive grants from the Administration for Community Living (ACL) to recruit and train retired professionals and other older adults and community members to prevent, detect, and report health care fraud, errors, and abuse. These SMP team members participate in outreach events to help educate Medicare and Medicaid beneficiaries on the same prevention, detection, and reporting techniques.
The OIG collects performance data from all the SMP programs annually to help ACL evaluate and improve the SMP programs nationwide. This year’s report once again illustrates the significant national impact of the SMP program in fraud education, detection and prevention and in recouping funds to the Medicare program.
For example, in 2023, the SMP program:
- Provided information to help older adults protect themselves from health care fraud, errors, and abuse at more than 22,000 events, reaching a total of 1.2 million people.
- Worked one-on-one with (or on behalf of) more than 270,000 Medicare beneficiaries — a 10% increase over 2022 — to provide information, advocate to resolve billing issues, and more.
- Reported 26 emerging fraud schemes, providing OIG with the information needed to alert consumers about risk and how to protect themselves.
The report also describes how the SMP program helped Medicare recoup more than $111 million in fraudulent billings and helped Medicare and beneficiaries avoid thousands of dollars in unnecessary costs. The report notes that these significant accomplishments represent only a portion of the financial benefits of the SMP program — in many cases, Medicare beneficiaries use the knowledge gained through SMP’s outreach and education programs to identify suspected fraud, which they then report through channels that are not connected to the SMP program (such as OIG’s Medicare hotline).
Read the full report: 2023 Performance Data for the Senior Medicare Patrol Projects, OEI-02-24-00260.
