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Senior Citizen's Guide to Pittsburgh

Preventing Medicare Fraud
The Pennsylvania Senior Medicare Patrol

SMP logoOver $48 billion dollars are lost to Medicare fraud and abuse each year.  Money lost to fraud means increased premiums for beneficiaries, increased taxes for all of us, and less money available for programs that assist caregivers.   In addition to the financial cost, there is a human cost.  Health care fraud diminishes the quality of care received by older adults and can result in the denial of medically necessary treatment. 

The U.S. Administration on Aging developed the Senior Medicare Patrol (SMP) to help consumers understand more about health care fraud.  Retired Medicare beneficiaries teach their peers about fraud and what they can do about it.  The message is simple: Protect your personal information, know how to Detect fraud, and know where to Report fraud.  CARIE, The Center for Advocacy for the Rights and Interests of the Elderly, a private, non-profit organization dedicated to improving the well-being, rights and autonomy of older adults, began the Pennsylvania SMP in 1997.  Through partnerships with AARP, APPRISE (PA’s health insurance counseling program), and RSVP, the PA-SMP has informed thousands about Medicare fraud prevention across Pennsylvania.  

What is Medicare Fraud?

Fraud occurs when an individual or organization deliberately deceives others in order to gain some sort of unauthorized benefit.  Medicare fraud generally involves billing for services that were never rendered or billing for a service at a higher rate than is actually justified.  It is important to note that most health care professionals are honest, trustworthy, and responsible.  The goal of this initiative is to weed out the few health care providers who operate by using Medicare as a pipeline to personal profit. 

Examples of Fraud 

What Can You Do?  Protect, Detect, Report

PROTECT

DETECT

REPORT

PA-SMP volunteers are available to speak to your group about Medicare Fraud.  To schedule a free presentation, or, to learn more about volunteering, please call Sue Anthony at 412-464-1300.  To learn more about the PA-SMP, please visit us online at www.carie.org/smp, or on Facebook: www.facebook.com/pennsylvaniasmp

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