(formerly, Senior Medicare Patrol Program)
The U. S. Office of Inspector General estimates that Medicare and Medicaid loses $60 billion dollars each year due to errors, fraud, waste, and abuse. Both the multiple systems for disbursing funds and the magnitude of health-care expenditures increase the probability of errors and create opportunities for fraud and abuse.
SMP was designed to reduce Medicare/Medicaid errors, fraud, and abuse by coordinating federal, state, local, and private resources to target educational and outreach efforts in order to raise awareness and encourage reporting by beneficiaries and others of suspected Medicare/Medicaid errors, fraud, and abuse. New York was one of the first five states funded by the Administration on Aging (AoA) in 1995 to participate in SMP. The New York State Office for the Aging (NYSOFA) generates public awareness about the mission of SMP, and NYSOFA collaborates with other state agencies that are involved in health-care-facility regulation, with legal entities that are authorized to prosecute health-care fraud and abuse, and with the provider community, resulting in recoupment of funds to the Medicare and Medicaid System.
SMP grantees recruit and train volunteers to conduct anti-fraud education and prevention in senior-oriented community events. Grantees collaborate with community organizations serving disabled, homebound, non-English-speaking, and hard-to-reach populations to ensure that the SMP message reaches these vulnerable, socially isolated populations. Grantees also encourage incorporation of the SMP message into their own organizations’ programs and their partner organizations’ programs. County partnerships play a critical role in fighting health-care fraud and abuse.
SMP established alliances with the New York State’s Department of Health, Office of Children and Family Services, Attorney General’s Office, Division of Criminal Justice, Office of the Comptroller, Medicaid Inspector General, Department of Insurance, and the Regional Center Medicare Services contractor and carriers. Partnerships establish methods for more efficient, global volunteer efforts; and they ensure advocacy with a unified voice for policy improvements in the State’s health care system, including solutions for health care system problems.