SMP Fraud Fact September 2023

The Missouri SMP (Senior Medicare Patrol) wants to remind you to read the mail that you
receive from Medicare. In doing so, you can help prevent Medicare fraud and abuse, which cost
taxpayers an estimated $60 billion annually.

One of the best ways to detect potential abuse or fraud on your Medicare account is to read
your Medicare Summary Notice, also known as a MSN.

The MSN is a notice that beneficiaries of original Medicare receive in the mail quarterly for
the services they have received for Medicare Part A and Part B-covered services.

If you have a Medicare Advantage plan and/or Part D drug coverage, you will receive an
Explanation of Benefits (EOB) with the same information.

These documents show the services and supplies that doctors and providers have billed to
Medicare (or the Advantage Plan) over the past three months. They also show you what
Medicare or the plan paid, and what you may owe the provider. If you don’t have services for the
previous three months, you will not receive an MSN or EOB.

You may use these important documents to compare your bills, receipts, and other medical
records with what Medicare has received and help you detect potential errors, abuse or fraud.

If Medicare or the Advantage Plan has been billed for a service that you do not believe you
received, then question it. Call the provider first to see if perhaps you did receive the service but
had forgotten or didn’t recognize it on the MSN. (One example would be that Medicare paid a
radiologist for reading an X-ray. The name of the radiologist is not familiar to you, but you
received the service.) Maybe the billing was an error. If you are not satisfied, call the Missouri
SMP at 1-888-515-6565 to report potential error, abuse, or fraud.

The Missouri SMP also can provide you with a personal health care journal that can be used
to keep track of your appointments, tests and other medical services. This is a free service, and
we can mail you one if you call 1-888-515-6565 and make the request.

This project was supported, in part by grant number 90MPPG0040, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.