Healthcare fraud happens when someone bills your health insurance, including Medicare, for:
Healthcare fraud is very common and occurs in every city, in every state, every day. If fraud happens to you, it is not your fault. Scam artists will do anything to gain our trust, and even the most sensible consumers can get “scammed.”
The best way to detect healthcare fraud is to read you Medicare Summary Notice (MSN) or your insurance’s Explanation of Benefits (EOB).
If you find a claim or charge for something that fits in the categories above, this may be a sign of errors, billing abuse or potential fraud. You can:
If you live in Illinois, call the Illinois SMP at AgeOptions 800-699-9043 (ask for “SMP”). If you live outside of Illinois, find your state’s SMP at www.smpresource.org.
The Senior Medicare Patrol (SMP) Program empowers consumers to prevent healthcare fraud. With volunteers and program staff, we help people with Medicare and Medicaid to Prevent, Detect, and Report Medicare & Medicaid fraud, waste, and abuse. The Administration for Community Living (ACL) provides funding to SMP programs in all 50 states, Washington, D.C., Puerto Rico, Guam, and the Virgin Islands.
In Illinois, AgeOptions is the statewide Illinois SMP. To find the SMP program in your state, visit the National SMP Resource Center website at www.smpresource.org and use the SMP Locator tool.
Yes! The Illinois SMP Program is a statewide program. Anyone in Illinois can call our Illinois SMP at AgeOptions hotline at (800)699-9043 (ask for “SMP”).
The Illinois SMP is headquartered at AgeOptions, the Area Agency on Aging for Suburban Cook County, and we work with several other agencies to provide information about healthcare fraud across Illinois. Our statewide partner agencies include the 12 other Illinois Area Agencies on Aging (click here to find the AAA serving your county):
While we take reports of all kinds of healthcare and Medicare fraud, the following are currently our most reported areas of fraud:
All areas of Medicare are subject to fraud. Please visit our SMP Materials page to find out more.
This project was supported, in part by grant number 90MPPG0036, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.