NEWSLETTER

OCTOBER — DECEMBER 2017 Published Quarterly

Editor, Kathleen Pursell—AR SMP Director

Senior Medicare Patrol (SMP) programs 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. SMPs are grant-funded

projects of the federal U.S. Department of Health and Human Services (HHS), U.S. Administration for Community Living (ACL).

The Department of Health and Human Services Office of Inspector General, along with our state and federal law enforcement

partners, participated in the largest health care fraud takedown in history in July 2017. More than 400 defendants in 41 federal

districts were charged with participating in fraud schemes involving about $1.3 billion in false billings to Medicare and Medicaid.

OIG also issued exclusion notices to 295 doctors, nurses, and other providers based on conduct related to opioid diversion and abuse.

Takedowns protect Medicare and Medicaid and deter fraud -- sending a strong signal that theft from these taxpayer-funded programs

will not be tolerated. The money taxpayers spend fighting fraud is an excellent investment: For every $1.00 spent on health care-

related fraud and abuse investigations in the last three years, more than $5.00 has been recovered.

National Health Care Fraud Takedown Results in Charges Against Over 412 Individuals Responsible for $1.3 Billion in Fraud Losses

A ttorney General Jeff Sessions and

Department of Health and Human

Services (HHS) Secretary

Tom Price, M.D., announced the

largest ever health care fraud enforcement

action by the Medicare Fraud Strike Force,

involving 412 charged defendants across 41

federal districts, including 115 doctors, nurses

and other licensed medical professionals, for

their alleged participation in health care fraud

schemes involving approximately $1.3 billion

in false billings. Of those charged, over 120

defendants, including doctors, were charged

for their roles in prescribing and distributing

opioids and other dangerous narcotics. Thirty

state Medicaid Fraud Control Units also

participated in today’s arrests. In addition,

HHS has initiated suspension actions against

295 providers, including doctors, nurses and

pharmacists.

Attorney General Sessions and Secretary

Price were joined in the announcement by

Acting Assistant Attorney General

Kenneth A. Blanco of the Justice

Department’s Criminal Division, Acting

Director Andrew McCabe of the FBI, Acting

Administrator Chuck Rosenberg of the Drug

Enforcement Administration (DEA), Inspector

General Daniel Levinson of the HHS Office of

Inspector General (OIG), Chief Don Fort of

IRS Criminal Investigation, Administrator

Seema Verma of the Centers for Medicare

and Medicaid Services (CMS), and Deputy

Director Kelly P. Mayo of the Defense

Criminal Investigative Service (DCIS).

These enforcement actions were led and

coordinated by the Criminal Division, Fraud

Section’s Health Care Fraud Unit in

conjunction with its Medicare Fraud Strike

Force (MFSF) partners, a partnership between

the Criminal Division, U.S. Attorney’s

Offices, the FBI and HHS-OIG. In addition,

the operation includes the participation of the

DEA, DCIS, and State Medicaid Fraud

Control Units.

The charges announced today aggressively

target schemes billing Medicare, Medicaid,

and TRICARE (a health insurance program

for members and veterans of the armed forces

and their families) for medically unnecessary

prescription drugs and compounded

medications that often were never even

purchased and/or distributed to beneficiaries.

The charges also involve individuals

contributing to the opioid epidemic, with a

particular focus on medical professionals

involved in the unlawful distribution of

opioids and other prescription narcotics, a

particular focus for the Department.

According to the CDC, approximately 91

Americans die every day of an opioid related

overdose.

“Too many trusted medical professionals like

doctors, nurses, and pharmacists have chosen

to violate their oaths and put greed ahead of

their patients,” said Attorney General

Sessions. “Amazingly, some have made their

practices into multimillion dollar criminal

enterprises. They seem oblivious to the

disastrous consequences of their greed. Their

actions not only enrich themselves often at the

expense of taxpayers but also feed addictions

and cause addictions to start. The

consequences are real: emergency rooms, jail

cells, futures lost, and graveyards. While

today is a historic day, the Department's work

is not finished. In fact, it is just beginning. We

will continue to find, arrest, prosecute,

convict, and incarcerate fraudsters and drug

dealers wherever they are.”

“Healthcare fraud is not only a criminal act

that costs billions of taxpayer dollars - it is an

affront to all Americans who rely on our

national healthcare programs for access to

critical healthcare services and a violation of

trust,” said Secretary Price. “The United States

is home to the world’s best medical

professionals, but their ability to provide

affordable, high-quality care to their patients is

jeopardized every time a criminal commits

healthcare fraud. That is why this

Administration is committed to bringing these

criminals to justice, as President Trump

demonstrated in his 2017 budget request

calling for a new $70 million investment in the

Health Care Fraud and Abuse Control

Program. The historic results of this year’s

national takedown represent significant

progress toward protecting the integrity and

sustainability of Medicare and Medicaid,

which we will continue to build upon in the

years to come.”

CONTINUED ON PAGE 2

INSIDE THIS ISSUE:

Volunteer Spotlight…...……... …Pg 3

INSIDE MEDICARE..............Pgs 4-5

Open Enrollment…………….…..Pg 5

Fraud in the News……..……….. Pg 6

Scams….………………..……… Pg 7

TERMINOLOGY…………...…..Pg 8

Upcoming Events………...……...Pg 9

“Guard Your Card”…...…….…Pg 10

Phone Numbers /Websites......... Pg 11

SMP Mission/Partners....…..…….Pg 12

Sign up to

receive SMP

SCAM

ALERTS

by calling

866-726-2916.

Medicare fraud occurs when healthcare services are deliberately misrepresented,

resulting in unnecessary costs to the program, improper payments to providers, or overpayments. Examples are billing for services that were never provided or billing

for a service or product at a higher rate.

Check your Medicare Summary Notice for suspicious charges and report them.

Sign up for www.mymedicare.gov to check claims regularly.

The Arkansas SMP can help!

Medicare Fraud, Waste & Abuse

TAKEDOWN 412 INDIVIDUALS

Continued from Page 1

According to court documents, the defendants allegedly participated in schemes to

submit claims to Medicare, Medicaid and TRICARE for treatments that were

medically unnecessary and often never provided. In many cases, patient recruiters,

beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return

for supplying beneficiary information to providers, so that the providers could then

submit fraudulent bills to Medicare for services that were medically unnecessary or

never performed. The number of medical professionals charged is particularly

significant, because virtually every health care fraud scheme requires a corrupt

medical professional to be involved in order for Medicare or Medicaid to pay the

fraudulent claims. Aggressively pursuing corrupt medical professionals not only

has a deterrent effect on other medical professionals, but also ensures that their

licenses can no longer be used to bilk the system.

“This week, thanks to the work of dedicated investigators and analysts, we arrested

once-trusted doctors, pharmacists and other medical professionals who were

corrupted by greed,” said Acting Director McCabe. “The FBI is committed to

working with our partners on the front lines of the fight against heath care fraud to

stop those who steal from the government and deceive the American public.”

“Health care fraud is a reprehensible crime. It not only represents a theft from

taxpayers who fund these vital programs, but impacts the millions of Americans

who rely on Medicare and Medicaid,” said Inspector General Levinson. “In the

worst fraud cases, greed overpowers care, putting patients’ health at risk. OIG will

continue to play a vital leadership role in the

Medicare Fraud Strike Force to track down

those who abuse important federal health

care programs.”

“Our enforcement actions underscore the

commitment of the Defense Criminal

Investigative Service and our partners to

vigorously investigate fraud perpetrated

against the DoD's TRICARE Program. We

will continue to relentlessly investigate

health care fraud, ensure the taxpayers'

health care dollars are properly spent, and

endeavor to guarantee our service members,

military retirees, and their dependents

receive the high standard of care they

deserve,” advised Deputy Director Mayo.

“Last year, an estimated 59,000 Americans died from a drug overdose, many linked

to the misuse of prescription drugs. This is, quite simply, an epidemic,” said Acting

Administrator Rosenberg. “There is a great responsibility that goes along with

handling controlled prescription drugs, and DEA and its partners remain absolutely

committed to fighting the opioid epidemic using all the tools at our disposal.”

“Every defendant in today’s announcement shares one common trait - greed,” said

Chief Fort. “The desire for money and material items drove these individuals to

perpetrate crimes against our healthcare system and prey upon many of the

vulnerable in our society. Thanks to the financial expertise and diligence of IRS-CI

special agents, who worked side-by-side with other federal, state and local law

enforcement officers to uncover these schemes, these criminals are off the street and

will now face the consequences of their actions.”

The Medicare Fraud Strike Force operations are part of a joint initiative between the

Department of Justice and HHS to focus their efforts to prevent and deter fraud and

enforce current anti-fraud laws around the country. The Medicare Fraud Strike

Force operates in nine locations nationwide. Since its inception in March 2007, the

Medicare Fraud Strike Force has charged over 3500 defendants who collectively

have falsely billed the Medicare program for over $12.5 billion.

SOURCE: https://oig.hhs.gov/newsroom/media-materials/2017/2017-takedown.asp 2

SCAM TIP! Government entities (Medicare and Social Security) will not call

you and ask for personal information!

The Arkansas SMP is currently recruiting volunteers!

COME JOIN THE FUN!

For more information, please contact Dee Edwards, Volunteer Coordinator

1-866-726-2916

SMP - Empowering Seniors to Prevent Medicare Fraud!

Really Special and Valuable People!Really Special and Valuable People!Really Special and Valuable People! SMP VOLUNTEERS IN THE SPOTLIGHT!

3

SMP Volunteer Wanda

Henry speaks to a lady

at the SMP exhibit

booth.

SMP Volunteer Lucy Bawel speaking to a

gentleman about Medicare fraud and abuse.

SMP Volunteer

Nancy Webb is happy to

help the SMP Program!

SMP Volunteer

Leta Bullard is getting

ready to share information

about Medicare fraud and

abuse. SMP Volunteer Shirley

Gardner talking to a

gentleman about guarding

his Medicare information.

NEW SMP VOLUNTEER TRAINING

MID DELTA COMMUNITY CONSORTIUM

Marvell AR — August 22, 2017

We are thrilled to have completed a volunteer

training with these amazing new volunteers from

MDCC! What an exceptional group! It was a

great training and so much fun meeting everyone!

Good job everyone! We are pleased to have each

one of you on our team!

NEW SMP VOLUNTEER TRAINING — SOUTHEAST ARKANSAS RSVP (SEARSVP)

Stuttgart AR — August 30, 2017 The training was held at the Grand Prairie Center in Stuttgart. Thank you Norma Strabala, SEARSVP Director; Leah Carter ,Volunteer

Coordinator; and Cindy Aycock, Administrative Assistant for your volunteer recruitment efforts! What a wonderful group of people

and a fun training! We truly look forward to working with each and every one of you!

El Dorado RSVP SMP Volunteers hard at work at the Head –to-Toe Wellness Event– Aug 24, 2017.

SMP is a nationwide federal grant program funded in part by the U.S. Administration for Community Living.

The Arkansas SMP is administered by the Arkansas Department of Human Services Division of Aging & Adult Services. 4

INSIDE MEDICARE— MEDICARE ISSUES PROJECTED

DRUG PREMIUMS FOR 2018

The Centers for Medicare & Medicaid

Services (CMS) announced that the

average basic premium for a Medicare

Part D prescription drug plan in 2018 is

projected to decline to an estimated

$33.50 per month. This represents a

decrease of approximately $1.20 below

the actual average premium of $34.70

in 2017.

“We are committed to making

prescription drug plan premiums

affordable so that seniors and people

with disabilities in Medicare can access

the prescription drugs that they need,”

said CMS Administrator Seema Verma.

“This projection is a step forward in

fulfilling the Trump Administration’s

promise to lower the cost of

prescription drug coverage, particularly

for Medicare beneficiaries.”

The upcoming annual Medicare open

enrollment period begins on October

15, 2017, and ends on December 7,

2017. During this time, Medicare

beneficiaries can choose health and

drug plans for 2018 by comparing their

current coverage and plan quality

ratings to other plan offerings or choose

to remain in traditional Medicare. CMS

anticipates releasing the premiums and

costs for Medicare health and drug

plans for the 2018 calendar year in

mid-September.

Call 1-866-726-2916 to receive the SMP Newsletter. You can read new and archived issues on our website

—www.daas.ar.gov/arsmp.html— 5

IMPORTANT INFORMATION

ABOUT MEDICARE AND YOU!

October 15 – December 7, 2017

The Medicare Open Enrollment Period begins on October

15th and lasts through December 7th. During this period,

Medicare beneficiaries can make changes to their existing plans

such as switching from their Original Medicare to a Medicare

Advantage Plan or vice versa, switching from one Medicare

Advantage Plan to another, and/or making changes regarding

Medicare Part D Prescription Drug Plans.

January 1 – February 14, 2018

The Medicare Advantage Disenrollment Period begins

January 1st and ends on February 14th . During this period you

can disenroll from Medicare Advantage and return to an

Original Medicare only with a prescription drug plan.

January 1 – March 31, 2018

The General Election Period (GEP) is January 1st through

March 31st . Coverage will not start until July 1st for those who

missed their Part B Enrollment.

For more information on Medicare

and these important dates,

contact the Arkansas SHIIP

1-800-224-6330

WHAT IS AN MBI?

Your new Medicare Number

is called a

Medicare Beneficiary Identifier

(MBI), and it is 11 characters in

length. Your unique identifier

will be made of numbers and

uppercase letters.

This new MBI number will replace

your old SSN-based Health

Insurance Claim Number (HICN).

Chronic care management services

How often is it covered?

If you have 2 or more chronic conditions that are expected to last at least a year, Medicare may pay for a health care professional’s help to manage those conditions.

Chronic care management offers additional help managing conditions like arthritis, asthma, diabetes, hypertension, heart disease, and osteoporosis. Services may include:

At least 20 minutes per month of chronic care management services.

Personalized help from a dedicated health care professional who will work with you to create a care plan based on your needs and goals.

Care coordinated between your doctor, pharmacy, specialists, testing centers, hospitals, and other services.

Phone check-ins between visits to keep you on track.

Emergency access to a health care professional, 24 hours a day, 7days a week.

Expert help with setting and meeting your health goals.

Who's eligible?

All people with Part B are covered. To get started, ask your health care professionals if they provide chronic care management services.

Your costs in Original Medicare You may pay a monthly fee, and the Part B deductible and co-insurance apply. If you have a supplemental insurance, or have both Medicare and Medicaid, it may help cover the monthly fee.

Source: https://www.medicare.gov/coverage/chronic-care-management-services.html

Senior Health Insurance

Information Program (SHIIP)

Contact Arkansas SHIIP

800-224-6330 for free, unbiased personalized,

one-on-one counseling and assistance with

understanding Medicare! They also help low-income seniors and

adults with disabilities enroll in cost-saving benefits.

FRAUD IN THE NEWS —

Woman Indicted for Running Health Care Fraud Scheme from Prison DALLAS — A female prisoner was indicted one count of conspiracy to commit health care fraud, four counts of

health care fraud, and four counts of aggravated identity theft in connection with a false billing scheme she ran

from prison that involved the submission of more than $810,000 in false claims to Medicaid. As part

of that scheme, she used the identities of licensed counselors and Medicaid clients without their knowledge or

consent to submit claims to Medicaid for psychotherapy services that were not provided. She was sentenced to

105 months in federal prison and ordered to pay $2,969,045.97 in restitution to Medicaid.

If convicted, each count of conspiracy to commit health care fraud and substantive health care fraud carries a

maximum statutory penalty of 10 years in federal prison and a $250,000 fine. The aggravated identity theft

counts carry a mandatory statutory penalty of two years in federal prison and a $250,000 fine.

In a similar scheme, the indictment alleges that she, a non-licensed psychotherapist or other mental health

provider, controlled and operated two counseling companies after obtaining a group Medicaid provider number,

then obtained the individual Medicaid provider numbers of licensed mental health professionals by soliciting

applications for job opportunities on Craigslist but not hiring the individuals who applied. She and her

co-conspirators used these numbers, together with the names, dates of birth, social security numbers, and

Medicaid numbers of approximately 156 Medicaid clients—mostly minor children—to submit claims for services

that were not performed.

As a further part of the scheme to defraud, she opened a bank account and leased office space in Tyler and

Waco and used these locations to conceal the fraud from the law enforcement authorities and for various

Medicaid applications and submissions. Neither office space was ever occupied or used.

SOURCE: https://www.justice.gov/usao-ndtx/pr/woman-indicted-running-health-care-fraud-scheme-prison

Opioids in Medicare Part D: Concerns about Extreme Use and Questionable Prescribing Opioid abuse and overdose deaths are at epidemic levels in the United States. The Office of Inspector General

(OIG) is stepping up efforts to fight the opioid crisis and address one of its top priority outcomes-to protect

beneficiaries from prescription drug abuse. Some beneficiaries receive extreme amounts of opioids and appear

to be "doctor shopping," while there are providers/prescribers who show questionable opioid prescribing

patterns.

Based on an analysis of prescription drug event records of opioids received in 2016 the OIG determined:

· One in three Medicare Part D beneficiaries received a prescription opioid in 2016;

· About 500,000 beneficiaries received high amounts of opioids;

· Almost 90,000 beneficiaries are at serious risk; some received extreme amounts of opioids, while others

appeared to be doctor shopping;

· About 400 prescribers had questionable opioid prescribing patterns for beneficiaries at serious risk; these

patterns are far outside the norm and warrant further scrutiny.

Prescribers play a key role in combatting opioid misuse. The OIG will address the issue of prescribers with

questionable prescribing patterns for opioids to ensure that Medicare Part D is not paying for unnecessary drugs

that are being diverted for resale or recreational use. OIG is committed to continuing investigations and

evaluations to address this issue. The OIG also encourages Part D sponsors to effectively use CMS's

Overutilization Monitoring System, which identifies beneficiaries who are potentially over utilizing opioids. By

working together and expanding their efforts in Part D, these agencies an sponsors can help curb the opioid

crisis in our Nation.

SOURCE: https://oig.hhs.gov/oei/reports/oei-02-17-00250.asp

The Arkansas Senior Medicare Patrol (SMP) is federally funded by a grant from the Administration on Aging (AoA) Administration for Community Living (ACL) and administered by the Arkansas Department of Human Services, Division of Aging & Adult Services

6

If you want to take an active role, join the Senior Medicare Patrol (SMP), a nationwide network of volunteers who educate the public about Medicare fraud. Contact the Arkansas SMP for more information or to volunteer by calling 866-726-2916.

Be aware of SCAM(s):

Report all scams to the Arkansas SMP — 1-866-726-2916

This newsletter is paid for by a grant (#90MP0022101) from the Administration for Community Living. Its contents are solely

the responsibility of the Arkansas SMP and do not necessarily represent the official views of ACL.

By Nat Wood

June 20, 2017

7

The first and best line of defense against fraud is you. You can help fight Medicare fraud in 2 simple steps:

1. Protect your Medicare number—treat it like you treat your credit card number.

2. Check your Medicare statement for errors, like supplies, equipment or services you never received.

WATCH OUT FOR SCAMS!

Scam artists may try to get your current

Medicare number and other personal

information by contacting you about your

new Medicare card. They often claim to be

from Medicare and use various scams to get

your Medicare number, including:

Asking you to confirm your Medicare

or Social Security number so they can

send you a new card.

Telling you there is a charge for your

new card and they need to verify your

personal information.

Threatening to cancel your health

benefits if you don’t share your

Medicare number or other personal

information.

Things you should know about your new Medicare card:

You don’t need to take any action to

get your new Medicare card.

The new card will not change your

Medicare coverage or any benefits.

Medicare will never ask you to give

personal or private information to get

your new Medicare number or card.

There is no charge for your new card.

Your new card may arrive at a different

time than your spouse’s, or a friend’s or

neighbor’s.

Your new Medicare card will no longer

have a signature line.

Your new Medicare card will no longer

show gender. SCAM TIP!

Government entities like

Medicare and Social Security

will not call you and ask for

personal information!

Tech-savvy seniors get online

Did know that some older adults never go online? You may

have a friend or family member who’s reluctant because

they don’t think their information will be safe. They might

feel better if you share some ways they can protect

themselves online.

Here are some tips to use and share:

Create strong passwords. Longer is stronger.

Passwords can protect your accounts, like email or social

media, and can also protect your devices. They keep

your information and photos safe if your device ends up

in someone else’s hands. Use different passwords for

your devices than the passwords you have for online

accounts.

Use only secure sites when shopping or banking

online. Look for a “lock” symbol or “https” at the start

of the website’s name. If you don’t see those, then don’t

enter any personal or financial information. Also, don’t

click on links in emails. Links may download malware,

malicious software that can weaken your computer's

security. Or they might direct you to scam sites.

Don’t use public Wi-Fi to access personal or financial

information when you’re on-the-go. That means the

library, coffee shop or airport are usually not the safest

places to check your online banking or medical records.

On social media, adjust your privacy settings so

you’re comfortable with who’s seeing your information.

For example, you may want only “friends” or

“followers” to see your posts. Also, it’s safest to avoid

posting information like your phone number, full date of

birth, address, or when you’re going out of town.

By sharing these tips, you can help others feel more

confident about staying safe online.

Medicare does not contact

beneficiaries asking for Medicare

numbers or other personal

information; HOWEVER, you

may receive a call from Medicare:

If you have granted permission in advance or;

If you have left a message requesting a call-back.

Social Security may call beneficiaries for customer

service purposes, but will NEVER ask for personal

information.

Medicare Advantage or prescription drug plans

may call if you are already a member of that plan.

If you are not sure if a call from Medicare or Social

Security is legitimate, HANG UP and call the agency

back on their toll-free customer service line:

Medicare—(800) 633-4227 or Social Security—

(800) 772-1213.

HANG UP ON PHONE

FRAUD!

GUARD YOUR CARD!

Con artists will try to get

your Medicare number to

commit Medicare fraud.

Protect your identity and guard your card. New Medicare

cards without social security numbers will be mailed next

year.

Watch the new video released by CMS related to your new

Medicare card—

https://www.youtube.com/watch?v=5KZpPrqMqCc

Something to know:

During the transition period beginning April 1, 2018

through December 31, 2019 providers may use either the

older HICN number or newer MBI number to file claims

with your insurance. BEGINNING JANUARY 1, 2020,

ONLY THE NEW MBI NUMBER CAN BE USED.

TERMINOLOGY:

Home Health Care or Home Care—What’s the Difference?

What is Home Health Care?

Home health care is skilled care to help someone get healthy while at home. It comes after a doctor’s visit or a hospital stay, and is

provided by medical professionals:

Skilled nursing

At-home physical therapy

Pain Management

Caring for wounds

Prescription management

What is Home Care?

Home care is non-medical care that helps in sustaining and maintaining your loved one’s quality of life in their home – keeping

them safe and comfortable. Medicare generally does not cover this type of care:

Custodial care such as personal grooming like bathing and/or getting dressed.

Moving around: getting in and out of the bed/shower.

Medication reminders.

Helping a person with Alzheimer's or Dementia by grounding and orienting them.

Errands like grocery shopping and picking up prescriptions.

SSDI or SSI – What’s the Difference?

Social Security administers two different programs that pay disability benefits. What it means to be disabled is the same for

both programs — a condition(s) making the person unable to work and that is expected to last at least a year or to end in death. But

each has a different set of rules and serves a different purpose.

Social Security Disability Insurance (SSDI) requires that a person have earnings that are taxed by Social Security to become

eligible for benefits. The minimum required varies from as little as one and one-half years for a younger worker and up to 10 years

for an older worker. Social Security determines the monthly benefit payable based on the averaged earnings of the worker. Benefits

are paid from the Social Security Disability Trust Fund. For most workers, family benefits for eligible spouses and children are

available. After 24 months of receiving benefits, the disabled individual becomes entitled to Medicare.

Supplemental Security Income (SSI) payments are paid from the general tax fund. SSI legislation determines the SSI payment

amount, which increases when a cost of living adjustment occurs. Payment goes to the disabled individual, which can include

children and both members of a disabled couple, if they qualify. Generally, receiving SSI gives the disabled person access to

Medicaid (a state health care program). There is no work history requirement to get SSI, but it does have requirements about income

and resources. 8

Upcoming Arkansas SMP Activities DATE ACTIVITY COUNTY

October 4 SMP Exhibit — AHAA Annual Conference — Embassy Suites — Little Rock Pulaski

October 7 SMP Exhibit — Antique Car Show at Davis Life Care Center — Pine Bluff Jefferson

October 10 SMP Presentation—S.A.L.T. (Seniors and Law Enforcement working Together )— Bella Vista

Benton

October 18 SMP Presentation — Audubon Pointe — Maumelle Pulaski

October 19 SMP Presentation — EHC Meeting—Trinity Lutheran Church Pulaski

October 21 SMP Presentation and Exhibit — Arkansas Democrat-Gazette SENIOR EXPO— Statehouse Convention Center — Little Rock

Pulaski

October 27 Hope for the Future—Magnolia Columbia

October 27 SMP Presentation— 8th Street Missionary Baptist Church—NLR Pulaski

November 14 SMP Presentation — Jacksonville Towers — Jacksonville Pulaski

November 17 Arkansas Gerontological Society (AGS) FALL SYMPOSIUM — Pulaski Heights UMC—Little Rock

Pulaski

December 5 SMP Volunteer Appreciation Event Pulaski

December 7 SMP Presentation — Alzheimer’s Arkansas Lunch & Learn —Faith UMC — Little Rock

Pulaski

January 15 SMP Presentation — Arkansas Methodist Medical Center Auxiliary — Paragould Greene

February 28 SMP Presentation — Forrest City Medical Center Auxiliary St. Francis

March 12 SMP Presentation — Northeast Arkansas Baptist Memorial Auxiliary — Jonesboro Craighead

March 14 SMP Presentation — Mena Regional Health System Auxiliary — Mena Polk

April 10 SMP Presentation — EHC Cleburne County —- Heber Springs Cleburne

We would welcome any opportunity to present the SMP message statewide.

Please contact the Arkansas SMP to schedule a presentation in your area—1-866-726-2916.

DEE-Tales!

Oh...Say Can You See? My dad has a terrible issue with laying his glasses down and then forgetting where they lay. Many of us can relate to that, but this particular incident is only something that would happen in Pappy’s world… Several years ago my dad purchased a repossessed motel called the Lazy8. This motel underwent major repairs before opening, all performed by Pappy.

Pappy was working every day to get the motel ready for opening day. As he worked in unit 6 he would take several breaks due to the heat, and when he would appear in the house for a rest period my mom would ask, “where are your glasses?” Pappy would quickly grab his shirt pocket and respond, “nope not there…I guess I left them in the room.” After a few weeks my mom noticed he still wasn’t wearing his glasses and asked where they were. Pappy admitted they were lost and he had to purchase a new pair.

Let’s fast forward about 5 years…there was a short in the overhead light in unit 6, and to fix it Pappy had to cut a hole in the wall at the switch. When he removed the wall board…low and behold there on the wall joist lay his glasses! Pappy exclaimed, “Wow…I knew I left them in this room!”

Dee-Tales courtesy of Dee Edwards,

SMP Volunteer Coordinator

9

This newsletter was supported in part by a grant (No. 90MP0022101) from the Administration for Community Living (ACL). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not necessarily represent official ACL or DHHS policy.

www.facebook.com/arsmp

Unreported fraud, waste, and abuse in Medicare and Medicaid

can cost taxpayers millions of dollars each year.

PROTECT, DETECT & REPORT 866-726-2916

CHECK IT OUT!

Do you find yourself receiving unsolicited

mail requesting donations to various charities

you have never heard of? You want to give,

but aren’t sure if they are a legitimate charitable

organization!

BEFORE GIVING ANY MONEY, check out the charity

online to determine if it is legitimate or worthy of your

money. Log on to the “CHARITY NAVIGATOR—Your

Guide to Intelligent Giving” at www.charitynavigator.org.

The Arkansas SMP

warns of the risk of

identity theft when

carrying your Social

Security card in your

wallet! However, if you insist on

carrying your Social Security card,

protect yourself by making a

photocopy of your card and scratch

out all but the last four digits of the

number!

The number of identity theft victims age 65 or older increased

from 2.1 million in 2012 to 2.6 million in 2014. In fact,

thieves consider your Medicare number and other protected

health information more valuable than credit card information because they can reuse them

to bill Medicare for services that you didn’t get.

10

IDENTITY THEFT: PROTECT YOURSELF

Identity theft is a serious crime that happens when someone uses your personal information without your consent to commit fraud or other crimes. Personal information includes things like your name and your Social Security, Medicare, or credit card numbers.

GUARD YOUR CARD! And protect your personal information To help protect your identity, Medicare is mailing new Medicare cards. Your new card will have a new Medicare Number

that’s unique to you, instead of your Social Security Number.

Don’t share your Medicare Number or other personal information with anyone who contacts you by phone, email, or by approaching you in person, unless you’ve given them permission in advance.

Medicare, or someone representing Medicare, will only call and ask for personal information in these situations:

A Medicare health or drug plan can call you if you’re already a member of the plan. The

agent who helped you join can also call you.

A customer service representative from 1-800-MEDICARE can call you if you’ve called

and left a message or a representative said that someone would call you back.

Only give personal information like your Medicare Number to doctors, insurers acting on your behalf, or trusted people in the community who work with Medicare like the Arkansas SHIIP Program (Senior Health Insurance Information Program).

If someone calls you and asks for your Medicare Number or other personal information, hang up and call the Arkansas SMP at 1-866-726-2916 or Medicare at 1-800-Medicare (1-800-633-4227).

IMPORTANT PHONE NUMBERS:

AANHR—AR Advocates for Nursing Home Residents 501-450-9619

AFMC—AR Foundation for Medical Care 1-888-354-9100

Area Agency on Aging 1-800-986-3505

AG-Attorney General (Consmr Prot Div) 1-800-482-8982

AG Medicaid Fraud Hotline 1-866-810-0016

APS—Adult Protective Services (DHS) 1-800-482-8049

Arkansas Rehabilitation Services 1-800-981-4463

AR SMP (Healthcare Fraud Complaints) 1-866-726-2916

Better Business Bureau (BBB) 501-664-7274

CMS—(Medicare)— (Centers for Medicare and Medicaid Services)

(1-800MEDICARE) 1-800-633-4227

Community Health Centers of AR 1-877-666-2422

Coordination of Benefits 1-855-798-2627

DHS (Customer Assistance Unit) 1-800-482-8988

Do Not Call Registry 1-888-382-1222

Elder Care Locator 1-800-677-1116

El Dorado RSVP 1-870-864-7080

Federal Trade Commission

Report STOLEN IDENTITY 1-800-438-4338

ICan—Increasing Capabilities Access Network 501-666-8868

KEPRO -AR QIO(Quality Improvmnt Org.) 1-844-430-9504

Medicaid—(Claims Unit) 1-800-482-5431

Medicaid Inspector General (OMIG) 1-855-527-6644

MEDICARE (CMS 1-800-MEDICARE) 1-800-633-4227

Medicare Part D 1-877-772-3379

Medicare Rights Center 1-800-333-4114

Mid-Delta Community Consortium 1-870-407-9000

NCTRC (Nat’l Consumer Tech Resrc Cntr 1-877-808-2468

Oaklawn Foundation/Center on Aging 501-623-0020

OIG-Nat’l Medicare Fraud Hotline 1-800-HHS-TIPS

(OIG) Office of Inspector General 1-800-447-8477

OLTC—Office of Long Term Care 1-800-LTC-4887

OLTC—Abuse Complaint Section 501-682-8430

Ombudsman—State Ofc of Long Term Care 501-682-8952

Resource Center (ADRC) 1-866-801-3435

(DHS’S Choices in Living Resource Center)

RSVP of Central Arkansas 501-897-0793

Senior Circle (Northwest Health System) 1-800-211-4148

SHIIP (Senior Health Ins.Info Program) 1-800-224-6330

SMP Locator—(locate an SMP outside AR) 1-877-808-2468

SSA (Social Security Administration) 1-800-772-1213

Little Rock Office 1-866-593-0933

SSA Fraud Hotline 1-800-269-0271

South Central Center on Aging 1-866-895-2795

Texarkana Regional Center on Aging 1-870-773-2030

Tri-County Rural Health Network 1-870-338-8900

UALR Senior Justice Center 501-683-7153

UofA Cooperative Extension Service 501-671-2000

HELPFUL WEBSITES:

ADRC—AR Aging & Disability Resource Center (DHS)—

www.choicesinliving.ar.gov/

AR Advocates for Nursing Home Residents—

www.aanhr.org; e-mail: Info@aanhr.org

AR Long Term Care Ombudsman Program—

www.arombudsman.com

Arkansas 2-1-1—www.arkansas211.org

(Get Connected. Get Answers) —1-866-489-6983

Arkansas Aging Initiative—http://aging.uams.edu/?

id=4605&sid=6

Arkansas Attorney General—www.arkansasag.gov

Arkansas Attorney General Consumer Protection

Division—e-mail: consumer@ag.state.ar.us

Area Agencies on Aging—www.daas.ar.gov/aaamap.html

Arkansas Foundation for Medical Care—www.afmc.org

Arkansas SMP—www.daas.ar.gov/asmp.html

BBB (Better Business Bureau)— scams and alerts— https://www.bbb.org/scamtracker/arkansas/

CMS (Medicare) Centers for Medicare and Medicaid Services—

www.cms.hhs.gov

Do Not Mail—www.DMAchoice.org

Elder Care Locator—www.eldercare.gov

H.E.A.T—www.stopmedicarefraud.gov/

(Healthcare Fraud Prevention and Enforcement Action Team)

ICan AT4ALL—Tools for Life—www.ar-ican.org

MEDICAID—www.Medicaid.gov

MEDICAID INSPECTOR GENERAL (OMIG)—

http://omig.arkansas.gov/fraud-form

MEDICARE—www.medicare.gov

Medicare Interactive Counselor—

www.medicareinteractive.org

Hospital Compare—www.hospitalcompare.hhs.gov

MyMedicare.gov—www.mymedicare.gov

(Access to your personal Medicare claims information)

MyMedicareMatters.org (National Council on Aging)

Office of Long Term Care—http://

humanservices.arkansas.gov/dms/Pages/oltcHome.aspx

Office of Inspector General (OIG)—email:

HHSTips@oig.hhs.gov

Pharmaceutical Assistance Program—

medicare.gov/pap/index.asp

Physician Compare—www.medicare.gov/find-a-doctor

SMP Locator—SMPResource.org (locate an SMP outside of AR)

Social Security Administration (SSA)—www.ssa.gov

SSA OIG—Report SS Fraud—https://oig.ssa.gov/report

TAP—www.arsinfo.org (Telecommunications Access Program)

UofA Cooperative Extension Service—

www.uaex.edu (or) www.arfamilies.org

Working Disabled—www.workingdisabled-ar.org 11

SENIOR MEDICARE PATROL (SMP) MISSION

“To empower and assist Medicare beneficiaries, their

families, and caregivers to prevent, detect, and report

health care fraud, error, and abuse through outreach,

counseling, and education.”

TO PREVENT HEALTHCARE FRAUD—

Protect Personal Information

* Treat Medicare/Medicaid and Social Security numbers like credit card numbers.

* Remember, Medicare will not call or make personal visits to sell anything!

* READ and SAVE Medicare Summary Notices (MSN) and Part D Explanation

of benefits (EOB), but shred before discarding.

Detect Errors, Fraud, and Abuse

* Always review MSN and EOB for mistakes.

* Compare them with your Personal Health Care Journal.

* Visit www.mymedicare.gov to access your personal account online to look

for charges for something you did not get, billing for the same thing more than

once, and services that were not ordered and/or you never received.

Report Mistakes or Questions

* If you suspect errors, fraud, or abuse, report it immediately! Call your provider

or plan first.

* If you are not satisfied with their response, call the Arkansas SMP.

TO RECRUIT & TRAIN VOLUNTEERS—

* Retired seniors;

* Retired health-care providers; or

* Retired professionals, e.g., teachers, accountants, attorneys, investigators, nurses.

Arkansas Senior Medicare Patrol (SMP)

P. O. Box 1437 Slot S530

Little Rock, AR 72203-1437

http://www.daas.ar.gov/asmp.html

FACEBOOK.COM/ARSMP

AR SMP PARTNERS

El Dorado Connections RSVP El Dorado, AR 870-864-7080

RSVP of Central Arkansas Little Rock, AR 501-897-0793

Oaklawn Foundation Hot Springs, AR

Mid Delta Community Consortium West Helena, AR

870-407-9000

Tri County Rural Health Network Helena, AR

870-338-8900

Texarkana Regional Center on Aging

Texarkana, AR 870-773-2030

South Central Center on Aging Pine Bluff, AR 870-879-1440

South East Arkansas RSVP Pine Bluff and Stuttgart, AR

870-673-8584

Senior Health Insurance Information Program (SHIIP)

Little Rock, AR 800-224-6330

To receive the Arkansas SMP Newsletter electronically

email: kathleen.pursell@dhs.arkansas.gov

Current and archived newsletters available at:

www.daas.ar.gov/asmpnl.html

To Report Medicare Fraud, Waste & Abuse

Call the Toll-Free Helpline 8:00am—4:30pm

1-866-726-2916