Frequently Asked Questions

QUESTIONS

  1. What is the Massachusetts Senior Medicare Patrol (SMP) Program?
  2. What is Healthcare Fraud?
  3. How can I detect Healthcare Fraud?
  4. What can I do to protect against Healthcare Fraud?
  5. Where can I report Medicare Fraud?
  6. Is there a legal service to help with Medicare legal issues and/or  unprofessional healthcare services?
  7. What steps do I take if I am a victim of identity theft?
  8. How does the Affordable Care Act impact my Medicare coverage?
  9. What organizations and services are available to Massachusetts seniors and their families?
  10. How can I be more informed about my healthcare?
  11. How can I personally make a difference?

ANSWERS

  1. What is the Massachusetts Senior Medicare Patrol (SMP) Program?
    The MA SMP Program program educates beneficiaries, family members, caregivers and professionals on how to detect, prevent and report healthcare errors fraud and abuse.
  2. What is Healthcare Fraud?
    Healthcare fraud is when a provider, organization or an individual or deliberately deceives Medicare, another insurer or another beneficiary in order to gain some sort of unauthorized payment.
  3. How can I detect Healthcare Fraud?
    Review all medical bills, Medicare Summary Notices (MSN) and Explanation of Benefits (EOB). Ask the following questions:

    • Were all listed services and prescriptions lreceived?
    • Is beneficiary being billed for a service or procedure she/he did not receive?
    • Did the doctor order these services?
    • Do the prescriptions listed match the prescription received?
    • Is a single service billed more than once?
    • Are the dates of services correct?
    • Are the dollar amounts questionable?
  4. What can I do to protect against Healthcare Fraud?
    • Protect your personal information. Treat your Medicare card as you would any credit card.
    • Don’t leave your Medicare number on a phone message or send it in an email.
    • Don’t accept offers of money, free food or gifts in exchange for Medicare number. Remember: Medicare numbers are Social Security numbers.
    • Legitimate offers of free medical testing do not require the presentation of a Medicare number.
  5. Where can I report Medicare Fraud?
    Massachusetts Senior Medicare Patrol Program 800-892-0890
    Massachusetts Attorney General’s Office 617-727-2200
    Centers for Medicare and Medicaid Services 800-Medicare or 800-633-4227
    Medicare Fraud Strike Force, 800-Medicare or 800-633-4227
  6. Is there a legal service to help with Medicare legal issues and/or  unprofessional healthcare services?
    The Medicare Advocacy Project (MAP) www.GBLS.org; 800-323-3205
  7. What steps do I take if I am a victim of identity theft?
    You are a victim of identity theft, if someone steals your personal information and uses it without your permission.  This is a serious crime and wreaks havoc with your credit, possibly your finances and even your reputation; it can take a long time and effort to resolve.   It can also be very costly.  First thing you should do is contact the Federal Trade Commission (FTC), the nation’s consumer protection agency.  They will guide you in repairing the damage that identity theft can cause, and reduce the risk of identity theft happening to you.  Visit www.identitytheft.gov to file a report and get started with a recovery plan.  The following are numbers for the FTC and Credit Bureau which you should also contact immediately.
    Contact the Federal Trade Commission (FTC), www.ftc.gov
    (877) 438-4338
    (202) 326-2502 (TDD) Credit Reporting BureausEquifax, www.equifax.com
    (800) 685-1111—For Credit Reports
    (800) 525-6285 – To Report Fraud
    (800) 255-0056— To Report Fraud—(TDD)Experian, www.experian.com
    (888)-397-3742 – For Credit Reports
    (888)397-3742  –  To Report Fraud
    (800) 972-0322  – To Report Fraud –(TDD)TransUnion, www.transUnion.com
    (800) 916-8800—For Credit Reports
    (800) 680-7289—To Report Fraud
    (877) 553-7803— To Report Fraud—(TDD)
  8. How does the Affordable Care Act impact my Medicare coverage?
    Changes to Medicare insurance 2013-2014:
    For Seniors with Medicare insurance or Medicare Advantage not much will change under the Affordable Care Act  (Click Here To Enroll) ( ObamaCare (Click Here To Enroll). Most seniors will enjoy the benefits, rights and protections of the new health care( Click Here To Enroll) law like expanded access to wellness visits, preventative care and drugs with little or no change to their insurance costs. Although most seniors will have nothing to worry about, some higher earning seniors may see their Medicare or Medicare Advantage premiums rise slightly or be affected by some taxes like the capital gains tax.
  9. What other organizations and services in Massachusetts help seniors and caregivers with health care questions and concerns?
    MA SMP Partners
  10. How can I be more informed about my healthcare?
    Keep an SMP Health Care Journal
    Report any concerns to: add links such as your healthcare provider, MA SMP Program
  11. How can I personally make a difference in spreading the word about the work of the Senior Medicare Patrol Program in controlling errors, fraud and abuse?
    Volunteer with us!
    Senior Medicare Patrol Volunteer Program
    Call to Action Form

 

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