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Senior Medicare Patrol (SMP)

The mission of the Senior Medicare Patrol (SMP) is to empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education.  

Qualifications  

• Good oral communication and public-speaking skills 

 • Ability and willingness to learn and share information related to preventing, detecting, and reporting health care billing mistakes, fraud, and abuse  

• Ability to work and get along well with others from diverse backgrounds  

• Ability to travel to presentation sites throughout the community  

• Valid driver's license  

• Automobile (or other vehicle) Insurance 

 

Time Commitment Volunteer schedules are flexible. The local SMP volunteer coordinator works with each volunteer to determine the number of hours the volunteer works each month, and to schedule assignments accordingly. Because of the training volunteers who make group presentations receive, they are asked to commit to a minimum of one year. Location Volunteers who make group presentations work at locations throughout the community. 

Idaho SMP is supported by four classifications of roles.  

  • Assisting with administration/clerical: This role involves such work as copying, filing, data entry, and placing outbound phone calls in support of SMP activity 
  • Outreach-related roles: Volunteers in these roles work to spread awareness of the SMP program. Each of these roles has its own role description.
    • Making Group Presentations:This role involves giving presentations to audiences regarding SMP topics to small and large groups, whith the opportunity for interaction with the audience during the time set aside for Q&A.
    • Staffing exhibits and events: this role involves staffing information kiosks or exhibits at events such as health fairs. Volunteers provide general information about SMP to the public and answer simple inquiries.
    • Distributing information: This role involves transporting and disseminating SMP information materials to sites and events, and may include presenting prepared copy or performing scripted activities for small groups. Volunteers who work in this role do not engage in discussions about personal information or situations.
  • Counseling: This role involves direct discussion with beneficiaries about their individual situations and may include review of personal information such as Medicare Summary Notices, billing statements and other related financial and health documents.
  • Handling complex issues and referrals: This role involves in-depth interactions with beneficiaries who are reporting specific instances of health care fraud, error, and abuse. Volunteers who serve in this role may act on behalf of a beneficiary to correct an error or refer suspected fraud and abuse to appropriate authorities. The SMP considers four roles— making group presentations, staffing exhibits, counseling, and handling complex issues and referrals—to be “positions of trust.” This means that the roles involve access to beneficiaries or other vulnerable people, personal or confidential information, or to money or other valuables. The four positions of trust are subject to more rigorous screening procedures than the roles involving administration and information distribution. If you decide to transfer from one role to another, please keep in mind that you may be required to undergo a more intensive screening process to qualify for placement in the new role. 

History:

The Senior Medicare Patrol (SMP) program was founded on the vision of Sen. Tom Harkin that retired senior volunteers could be trained to educate their peers about ways to prevent and identify Medicare fraud. In fact, Sen. Harkin believed that such senior volunteers may serve as the best defense against health care fraud, waste, and abuse.  Today, more than fifteen years later, the SMP program has grown to a national, visible, and respected partner in the fight against health care fraud. The evolution and growth of the program has brought expectations for greater consistency, quality, accountability, and results from SMP projects across the country. But one thing has not changed-- and that is that the program today, just as in Sen. Harkin’s vision, is founded on a trained, committed, and trustworthy volunteer workforce upon which the program relies to spread the message of health care fraud prevention throughout local communities. 

In 1995, the U.S. Administration on Aging (AoA) became a partner in a government-led effort to fight fraud, error and abuse in the Medicare and Medicaid programs through the implementation of a ground-breaking demonstration project called Operation Restore Trust (ORT). ORT’s purpose was to coordinate and target federal, state, local and private resources on those areas most plagued by abuse. Operation Restore Trust was announced at the 1995 White House Conference on Aging.   

It created a partnership in the U.S. Department of Health & Human Services (HHS) between CMS (Center for Medicare & Medicaid), the OIG (Office of Investigator General) and the AoA (Administration on Aging), which continue to work as a team in a coordinated anti-health care fraud effort at the local, state and national levels. 

 

For more information about SMP, call the volunteer coordinator at

(208) 522-5391. 

 

 

Link to SHIBA website  - http://www.doi.idaho.gov/SHIBA/shwelcome.aspx 

 


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