SMP Foundations Training Manual CHAPTER 1 ... - SMPresource.org

SMP FOUNDATIONS TRAINING MANUAL
National SMP Program Overview, continued
The Role of SMPs
The role of the Senior Medicare Patrol program is to:
1. Disseminate SMP fraud prevention and identification information through the
media, outreach campaigns, community events, and many other means.
2. Assist beneficiaries in resolving potential fraud-related inquiries and issues
regarding Medicare, Medicaid, and other health care or related consumer issues.
3. Make referrals of suspected cases of
fraud, waste, or abuse to appropriate
investigative entities, such as:
Medicare contractors
State Medicaid Fraud Control
Units (MFCU)
State Attorneys General (AG)
Department of Health and
Human Services’ Office of
Inspector General (OIG)
Centers for Medicare & Medicaid
Services (CMS)
SMP Strategic Program Objectives
The SMP Message:
Protect, Detect, Report
SMPs provide seniors with
information to:
PROTECT themselves from
Medicare errors, fraud and abuse;
DETECT potential errors, fraud
and abuse; and
REPORT their concerns.
This message of “protect, detect,
report” is a core part of the SMP
program and is reviewed in greater
detail in chapter 3.
AoA regularly works in conjunction with state SMP programs to develop and refine
national program objectives. These objectives provide guidance and direction to the
local SMP programs. As part of the grant-seeking process, potential SMPs must
develop a set of activities that are designed to meet the needs of local communities
while contributing to a set of national program objectives.
The current SMP Strategic Program Objectives are to:
Foster National and Statewide Program Coverage: Statewide program
coverage is defined as service to each county within the state, each ward in the
District of Columbia, or jurisdiction in the territories.
Improve beneficiary education and inquiry resolution: Each SMP is required
to implement a plan for increasing the number of beneficiaries educated about
health care fraud through expansion of their volunteer capacity. This objective
includes specific requirements for recruiting, screening and training senior
volunteers.
SMP Foundations Training Manual May 2011
Chapter 1 – Page 4