Approximately $1 out of every $10 reimbursed by Medicare and Medicaid is lost to fraud, according to early U.S. General Accounting Office (GAO) estimates. This means fewer resources for people who depend on these programs for their health care, and puts severe strains on federal and state budgets. Because of these findings, President Clinton initiated an anti-fraud and abuse demonstration project in 1995 called Operation Restore Trust. It focused on home health, durable medical equipment, and nursing homes, the three fastest growing areas of Medicare.
In 1996, the Health and Human Services (HHS) Office of the Inspector General (OIG) received $70 million from the newly established Health Care Fraud and Abuse Control Account created under the Health Insurance Portability and Accountability Act (HIPAA). This landmark Act, signed into law by President Clinton in August 1996, created a stable source of funding for health care fraud control efforts. More than $2 million in grants funded by HIPAA were earmarked for new state programs to aid in the fight against health care fraud and abuse.
In 1997, the Minnesota Board on Aging became a partner in this national effort. A campaign called Medicare FYI was launched to increase public awareness in Minnesota. On January 1, 2007, the program became known as SMP. It continues to be an educational program that helps people understand healthcare, lets them know what they can do to reduce the incidence of healthcare fraud, abuse, and errors, and how they can take an active role in their healthcare.
For more information on events in your community, or to learn how you can volunteer to help fight healthcare fraud, abuse, and errors, call the Senior Community Outreach Services, your local SMP, at Toll Free at 1-866-943-7289.