The SMP mission is to empower and assist Medicare beneficiaries, their families, and caregivers on how to prevent, detect, and report health care fraud, abuse, and errors through outreach, counseling, and education. The Wisconsin SMP program covers 72 counties and 11 federally recognized tribes with our educational message and outreach. Our program engages and supports an active team, statewide, to help in mission delivery.
The Wisconsin SMP program is housed at the Greater Wisconsin Agency on Aging Resources (GWAAR).
The Wisconsin SMP team includes staff, partners, and volunteers. Our team is committed to expanding the SMP mission, reaching as many people as possible in every corner of the state.
How It All Started
Medicare was signed into law by President Lyndon B. Johnson on July 30, 1965, and at the start, the program accounted for only 2.3% of Federal spending. Now the Medicare and Medicaid program accounts for 23.5% of Federal spending. This program witnessed exponential growth in the number and types of providers Medicare includes, the type of benefits available, the number of claims processed and paid, and, perhaps most importantly, the number of dollars involved. Along with this growth through the years, so has the rate of fraud, abuse and errors increased.
In 1995, the U.S. Administration on Aging became a partner in a government-led effort to fight fraud, abuse, and errors in the Medicare and Medicaid programs through a ground-breaking demonstration project called Operation Restore Trust (ORT). ORT’s purpose was to coordinate and target federal, state, local, and private resources in those areas most plagued by abuse. ORT created a partnership in the US Department of Health & Human Services (HHS) with Centers for Medicare and Medicaid Services (CMS), the Office of Inspector General (OIG) and the Administration on Aging, which continue to work as a team in a coordinated anti-health care fraud effort on the local, state, and national levels.
In 1997, the Administration on Aging established 12 local demonstration projects designed to recruit and train retired professionals to identify and report fraud, abuse, and errors. Senate Report 104-368 noted that “senior citizens are our best front-line defense against these losses.” The SMP program as we know it today was made possible by the 1997 Omnibus Consolidation Appropriation Act – legislation that formally supported enlisting seniors in the fight against Medicare fraud.
The SMP Program Today
Since its inception in 1997, the SMP program has evolved from 12 regional demonstration projects to a nationwide program that serves every state, Guam, Puerto Rico, the U.S. Virgin Islands, and Washington, D.C.
SMPs are discretionary grant projects funded by the U.S. Administration for Community Living (ACL). (clickable link) ACL is headed by the Assistant Secretary on Aging, who is appointed by the president and serves under the U.S. Secretary for Health and Human Services. Every five years, ACL issues a new request for proposals for the SMP program and then competitively awards grants to a selected project in each of the 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands.
The SMP programs have been supported by an ACL-funded resource center since 2003. This national SMP Resource Center provides a website about the SMP program and provides direct technical assistance to the 54 SMP projects nationwide. To learn more about the Center, click here.
Senior Medicare Patrol (SMP) Mission
Senior Medicare Patrols (SMPs) empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, abuse, and errors 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). Their work is in three main areas:
Conduct Outreach and Education. SMPs give presentations to groups, exhibit at events, and work one-on-one with Medicare beneficiaries.
Engage Volunteers. Protecting older persons’ health, finances, and medical identity while saving precious Medicare dollars is a cause that attracts civic-minded Americans.
Receive Beneficiary Complaints. When Medicare beneficiaries, caregivers, and family members bring their complaints to the SMP, the SMP makes a determination about whether fraud, abuse, or errors is suspected. When fraud or abuse is suspected, they make referrals to the appropriate state and federal agencies for further investigation.