Senior and Disabilities Services

Medicare Fraud and Abuse

 

The U. S. Administration on Aging (AOA) funds the SMP project which educates and encourages Medicare beneficiaries and others to report suspected Medicare error, fraud, waste and abuse.

Senior Medicare Patrol

Use this link for great resources on preventing Medicare fraud

Medicare Summary Notice (MSN)

The Medicare Summary Notice is an easy-to-read statement that clearly lists your health insurance claims information. The MSN lists the details of the services you received and the amount you may be billed. These notices are sent by companies that handle bills for Medicare on a quarterly basis, unless you are due a payment check from Medicare. If you are due payment from Medicare, the MSN will be mailed to you as your claims are processed.
The MSN lists all the services or supplies that were billed to Medicare for a 90-day period of time. It is important to check this notice to be sure you got all the services, medical supplies, or equipment that providers billed to Medicare. If you have any questions or if you need an MSN for a particular claim before the quarterly mailing, call the phone number listed in the Customer Service Information box on the front of the MSN. If you disagree with a claims decision, you have the right to file an appeal. Follow the instructions on the MSN to file an appeal.


View an example of the new, simplified MSN Part B (PDF 79 KB)

View an example of the new, simplified MSN Part A (PDF 78 KB)

SMP Foundations: Volunteer Training are broken down into three chapters.

Chapter 1: SMP Program Introduction
Chapter 2: Medicare Overview
Chapter 3: Medicare Fraud & Abuse
Jeopardy Review Game

Please use this LINK for these chapters and other self-study online SMP volunteer training programs.

 

Links for Fraud Prevention

Be aware of ongoing scams

 

 

Click here for scams and the Affordable Care Act

Click here for common Health Care scams

Click here for common Medicare fraud

Click here for common Medicaid schemes