OIG: SMP projects have room for improvement
By HME News Staff
Updated 9:07 AM CDT, Wed June 18, 2025
WASHINGTON – Senior Medicare Patrol projects in 2024 made $35,115,211 in expected Medicare recoveries and $99,037 in cost avoidance on behalf of Medicare, Medicaid, beneficiaries and others, according to a new report from the Office of Inspector General (OIG). In 2024, SMP projects, which are funded by grants for the Administration for Community Living, had 5,643 active team members; conducted 22,752 group outreach and education events; and had 283,724 individual interactions with, or on behalf of, a Medicare beneficiary. The OIG says, however, that SMP projects may not be receiving full credit for recoveries, savings and cost avoidance attributable to their work. It is not always possible to track referrals to Medicare contractors or to law enforcement from beneficiaries who have learned to detect fraud, waste and abuse from the projects, it says. In addition, the projects are unable to track the potentially substantial savings derived from a sentinel effect, whereby scrutiny of bills by beneficiaries reduces fraud and errors, it says. The ACL, the OIG says, needs to work with SMP projects to further focus on and document expected Medicare and Medicaid recoveries; additional Medicare and Medicaid recoveries; cost avoidance and savings both to beneficiaries and to others to the extent possible.
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