Preventing Medicare Fraud: That’s the SMP Mission

Attention: Senior Medicare Patrols help protect your Medicare services.

Preventing Medicare fraud is not the primary goal of the agencies that provide Medicare benefits. CMS (The Centers for Medicare & Medicaid Services) and the Social Security Administration’s primary focus are helping you get the health coverage you qualify for. Of course, they try their best to protect you by providing information and warnings. Still, unscrupulous providers and outright criminals keep coming at seniors to steal their benefits, identity, and more.

The government spends nearly $1.25 trillion annually on Medicare benefits, serving close to 70 million Americans, which is about 20% of the population. So, you can see how much money is being spent on the program, tempting criminals and fraudsters.

And quite honestly, Medicare services can get confusing fast, and seniors have a hard enough time figuring out what benefits are available, who provides them, and whom to trust. It only serves to complicate matters for beneficiaries.

That’s where the Senior Medical Patrols come in.

SMPs are designed to empower and assist you in preventing, detecting, and reporting Medicare fraud, errors, and abuse. Any time you suspect or wonder about Medicare issues or incidents that seem puzzling, you can contact an SMP office for assistance with looking into it.

Locate the SMP Office in your state or territory. Click here SMP locations.

Senior Medicare Patrols are there to help seniors and all Medicare beneficiaries get the most out of the program without the negative impact of fraud, scams, or abuse.

The individual SMPs are actually projects that are funded by the United States Department of Health and Human Services (HHS) under the Administration for Community Living, or ACL.

• ACL falls under the Assistant Secretary for Aging, a position appointed by the President and serving under the HHS Secretary. These positions are important to the country and help protect Medicare assets.

Medicare: A program of immense scope and major importance.

The Medicare program provides much-needed health services to retirees and others who qualify for coverage. Health care providers work within Medicare guidelines to provide covered health care procedures and bill the federal Medicare program for reimbursement.

In 2026, the Baby Boomer generation (born between 1946 and 1960) comprises the majority of Medicare beneficiaries. Here’s a look at the enrollment breakdown:

• It’s an age thing: Ninety percent of all Medicare enrollees qualify by being age 65 or greater.
• The age exception: There are those (the other 10 percent) who may be eligible due to specific disabilities and medical conditions.
• Program options. In addition to standard Medicare (Plan A, hospital services), Medicare also offers Plan B (doctor care), Plan C (Medicare Advantage Plans), and Plan D (prescription drug coverage).

As mentioned before, it gets confusing very fast, which makes it hard for the average citizen to tell what’s genuine and what’s fraudulent. And that’s part of the challenge for both the government and citizens.

The cost of Medicare fraud and errors.

As you might expect, there is always the potential for Medicare scams and fraud because criminals and cheaters want to get money the easy way: By lying and deceiving seniors and the government system to get their unfair share of the pie.

Here is a glimpse of how fraud impacted the Medicare program in 2025 in terms of Medicare Improper Payments: Across all parts of the program, the federal government made an estimated $56.73 billion in improper payments.

1. Traditional Medicare (Fee-for-Service) accounted nearly $29 billion. 
2. Medicare Advantage (Part C) accounted for more than $23.5 billion.
3. Medicare Part D accounted for almost $4.25 billion.

The good news is, thanks to improved fraud detection systems, CMS reportedly stopped fraud and waste in action and before payments were sent out, saving $42 billion!

Preventing Medicare Fraud. The SMP mission.

In their own words, here’s how SMP defines its mission:

“Senior Medicare Patrols 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.”

• Reaching the community. SMPs often arrange presentations to seniors and providers, exhibit at health-related events, and work one-on-one with the public.
• Recruiting volunteers. SMPs are staffed heavily by civic-minded citizens who volunteer to help seniors protect their Medicare benefits, health, and medical identity.
• Handling (and forwarding) complaints. The SMP works closely with the appropriate state or federal agencies to address reported and alleged complaints about fraud, errors, or abuse.

Who you gonna call? Fraud busters.

Each SMP in the 50 states, Washington DC, Guam, Puerto Rico, and the U.S. Virgin Islands,  and the three territories, are referred to as individual SMP projects. They have been funded by the ACL for more than 20 years. The main SMP website is hosted by the SMP Resource Center, which also delivers contents to social media platforms, provides a toll-free telephone number, and an email exchange, newsletters and other key content.

To find the Senior Medical Patrol office serving your state, click on this link: smpresource.com. In addition to a wealth of information, you can also arrange for a free presentation or webinar on Medicare fraud. During the presentation, they’ll teach you the following:

• How to spot potential fraud
• What the latest Medicare scams are
• Tips for protecting your benefits, your health, and your family

Visit our Learning Center for additional resources.

To learn more about protecting yourself from all types of fraud and scams, visit the WhatIsMyIPAddress.com Learning Center. There, you can browse hundreds of articles and interviews to help you stay connected and safe.