Medicare Fraud

 

Medicare Fraud cannot continue if people are informed: they must prevent identity theft, review all statements of medical services provided and report all suspicious billings promptly. AgeOptions funds this program which is now in its second year.

What Is Medicare?

A health insurance program for People 65 years of age and older People under age 65 with certain disabilities.

People with End-Stage Renal Disease (ESRD)

Administered by Centers for Medicare& Medicaid Services (CMS)
Enrollment by Social Security Administration (SSA) or Railroad Retirement Board (RRB) )

Two very helpful Powerpoint Presentations
Welcome to Medicare 101! is designed to give you an overview of the Medicare program—and to let you know where you can get more information. (Ppt)

Medicare Fraud Program Training (Ppt)
Agenda, Basics of Medicare, Medicare Fraud Program, What is Fraud?
Tips & Resources to Combat Fraud, Areas of Health Care Fraud

AgeOptions

AgeOptions funds the Senior Medicare Patrol program which educates elderly about healthcare fraud.

AgeOptions has established a reputation for meeting the needs, wants and expectations of the senior population in suburban Cook County. Their purpose is to connect older adults, aged 60 and over, with resources and options for care so that they can have a full range of choices and live their lives to the fullest. Their role is to plan, fund, coordinate and advocate for this special group and their family caregivers.

Their primary service area includes 130 communities – home to more than two million residents with a population of almost 430,000 older adults. Together with their service partners, we annually reach more than 100,000 people who come to them from diverse backgrounds.

AgeOptions embraces diversity in aging – across race, ethnicity, culture, language, experience and lifestyle. These qualities contribute greatly to the richness of our communities. At the same time, the unique differences challenge us to regularly evaluate who we are and what we do.

The SMP Program

The SMP Program is a program funded through the U.S. Administration on Aging, which empowers Medicare and Medicaid beneficiaries to prevent healthcare fraud. Since 1997, through the efforts of SMP programs and beneficiaries across the country, over $105 million have been saved for Medicare, Medicaid and beneficiaries.  CLESE in cooperation with Age Options the area agency on aging of suburban cook county, assist people in ethnic communities with Medicare and Medicaid to:

1). PROTECT themselves from Medicare and Medicaid fraud, waste and abuse.

2). DETECT Medicare and Medicaid fraud, waste and abuse.

3). REPORT Medicare and Medicare fraud, waste and abuse.

CLESE and its member agencies are active participants in the fight against Medicare fraud and abuse. We translate and distribute monthly SMP Tips to ethnic communities as well as hold educational sessions on the prevention of fraud and abuse. CLESE distributes fraud alerts to its member agencies and works with its agencies to develop innovative ways to prevent fraud and abuse. Recently, CLESE helped to develop a bi-lingual ICE Card (In Case of Emergency) with Age Options to distribute to limited English speaking elderly.

Volunteer with the SMP Program!

The Illinois SMP Program needs volunteers to help give presentations, distribute information at community events, and help counsel others about fraud and abuse. All interested individuals are welcome! No experience is needed – we train and support all of our volunteers.

To find out more about volunteering with SMP, contact AgeOptions at (800)699-9043 (Voice) or (708)524-1653 (TTY).

Coalition of Limited English Speaking Elderly (CLESE)
53 West Jackson, Suite 1340
Chicago, IL 60604
312-461-0812  /  312-461-1466 (fax)
info@clese.org