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
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ttorney - AR Human Services€¦ · defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state
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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.
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.
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.
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
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
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
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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.
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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.
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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).