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Senior Medicare (Fraud) Patrol

 

South Carolina SMP’s purpose is to educate Medicare/Medicaid beneficiaries and caregivers about Medicare/Medicaid benefits in order to understand Medicare statements such as Medicare Summary Notices (MSN), Medicare Part D Prescription Drug Plan (PDP) Explanations of Benefits (EOB) and other related health care statements. Through this knowledge, a person can identify, resolve and/or report possible billing errors, fraud, abuse and waste to the SMP.

Unfortunately, unscrupulous people take advantage of the Medicare program. Here are some things you can do to protect yourself from Medicare fraud:

  • Treat Medicare, Medicaid and Social Security numbers like a credit card number. Never give out account numbers or other personal information to strangers.
  • Remember, Medicare representatives DO NOT make uninvited home visits or call to sell a prescription drug or health plan.
  • Review the MSN to look for charges for services or products that were not provided.
  • If the medical equipment or service is "free", be suspicious; ask questions before providing the Medicare number.

For more information there is a good Medicare Prescription Drug Coverage Fraud pamphlet that you can view online.

 

BE SMART, know your Medicare rights; be empowered to detect and report healthcare fraud.

The SMP Project works in collaboration with national and state fraud control units to help beneficiaries resolve complaints. If a billing error or fraud complaint cannot be resolved with the provider, a certified SMP counselor can be reached 1-800-868-9095 or assistance is available at the Fraud TIPS Hotline 1-800-447-8477.

Useful Links:

Medicare.gov

www.stopmedicarefraud.gov