1. Rebecca Kinney, ACL Marissa Whitehouse, ACL
Future of SMP
Rebecca Kinney, ACL
Marissa Whitehouse, ACL

2. Partnership with OIG

3. ACL Fraud Alerts
Official process to alert the OIG of concerning case trends or other widespread issues
Provides an overview of the issue
Excludes individual case details
OIG can ask for more details if needed
Not for public dissemination
Inaugural Fraud Alert – Genetic Testing
Sent June 13th

4. SMP Consumer Alerts
Created in conjunction with the Fraud Alerts for the OIG
Intended for public release
Allows us to get the word out on scams/issues more broadly with a consistent message
1st Consumer Alert was released in June 28th on Genetic Testing

5. Possible Updates to OIG Report
Goal: Broaden the Report to enhance the narrative
No plan to remove anything from the report; discussions have only been on adding
Possible additions we’re considering:
Tracking Fraud Alerts to OIG,
Tracking the Consumer Alert dissemination, and
Including Beneficiary Survey data
Report is about results; not outcomes. So how we’re doing, not what we’re seeing.

6. Opioid Fraud and Abuse
Fighting the national opioid epidemic is one of the Administrations top priorities
Please start reporting Opioid related cases to ACL via SIRS
Examples of cases that should be reported:
Medicare beneficiary is being over-prescribed pain medication,
Pharmacies may be involved in drug diversion involving opioids, or
Situations Medicare has been billed for prescriptions that that the beneficiary did not receive, or were not prescribed to the beneficiary.

7. New Casework Process
More to come during the “Life of a Case” at 10:35 am.

8. Updates and Enhancements
SIRS

9. SIRS Updates Coming Soon
90 Day Password Change Requirement – Now in Effect
Individual Interaction Form Updates
New Topics Discussed
Genetic/DNA Testing & Opioid Fraud and Abuse - Available Now
All “Other” Boxes will Require Text Explanation
Claim Information will be Removed
New section “Referred beneficiary to…” will be Added
Beneficiary Race and Gender will be Added
Individual Interaction Form Update
New Topics Discussed
Conditional Payments
Genetic/DNA Testing (available as of 7/20)
Medicare Summary Notice
Medicare Card
Opioid Fraud and Abuse (available as of 7/20)
All “Other” Box will have a box to add additional details and will be required if Other is selected
Removing Claim Information – this section was not often used and is being removed to save space on the form. The information input previously will be available through the search feature
New section “Referred beneficiary to…”
This section will help differentiate between actions the SMP took listed under “SMP Actions” and actions the SMP referred the beneficiary to take
Beneficiary Race and Gender Added

10. SIRS Updates Coming Soon
SIRS Team Member Form Updates
Aligning Race & Gender Data Collection with STARS
Adding Date of Birth
Send Credentials will be relabeled “Resend” after initial sending
Group Outreach & Media Outreach Forms Updates
Topics Discussed Updates
ACL/SMP Consumer Alert
New Reports launching soon!
Interaction Summary Report
Team Member “all-in-one” Report
Next Workgroup Meeting: August 6th at 3pm ET
SIRS Team Member Form Update
Aligning Race & Gender categories with what is collected in STARS
Adding Date of Birth
Send Credentials will be relabeled “Resend” after initial sending - Remove any send credential buttons after credentials have been sent (eFile, User Logins). Replace with a “Resend User Credentials” and “Resend eFile.”
Group Outreach & Media Outreach Forms Update
Topics Discussed Updates – these changes align with the updated Topics Discussed on the Individual Interaction for
ACL/SMP Consumer Alert
New Reports launching soon!
Interaction Summary Report – will give a count of all fields on the form so that we can learn more about the beneficiaries served and hot topics/common referrals
Team Member “all-in-one” Report – requested by the workgroup – will show the totals of all forms for team members

11. Beneficiary Survey Update

12. General Results Over 5000 total responses.
More in Year 2 (2700) than Year 1 (2300).
Over 80% of States/Territories generated over 100 responses, despite a request of 75 responses per State/Territory.
Results were extremely positive, particularly for question 3 (“Useful information”), 4 (“Overall satisfaction”) and 6 (“Recommendation”).
Little change from Year 1 to Year 2.
Very positive in both Years.

13. SMP Detailed Results

14. Survey Breakout
Year 1 - Red
Year 2 - Yellow
Year 3 - Blue
Not Shown: AK (Year 1), HI (Year 3), PR (Year 3), and VI (Year 3)

15. Year 3 States New Hampshire Alabama New York Delaware Puerto Rico
Florida
Georgia
Hawaii
Idaho
Iowa
Maryland
Montana
New Hampshire
New York
Puerto Rico
South Carolina
South Dakota
Texas
U.S Virgin Islands
Vermont
Wisconsin

16. SMP NATIONAL RESOURCE CENTER: YEAR TO COME

17. Center Activities Mentor Call updates National SMP video campaign
Personal Health Care Journal revamp
For those of you that attend mentor calls. They will continue to be held monthly, but starting in September of this year they will be held on the third Tuesday of the month instead of the second Tuesday of the month and there will only be one call instead of two calls on that day. The call will be at 2:00 pm ET. The mentor calls will also be renamed starting in September and you will be able to vote on the new name on the August mentor call. Please look for the new call series after the August mentor calls.
National SMP video campaign- The Center will be doing a national video campaign with ABC that will hit 20 major markets in the U.S. This will promote SMPs nationally and make the public more aware of the SMP program’s services and education resources that they have to offer.  
PHCJ revamp –The Center will be conducting the revamp of the PHCJ and steering a network work group to get ideas and information to provide the needed input for the revamp of the PHCJ.

18. Center Activities Additional SMP Videos for project use
SMP Foundation Manual and training resources updated
Redoing SMP Complex Interactions Manual and training resources
Additional SMP videos for project use: SMP mission promotional video (2 min & 30 sec) and types of Medicare fraud video (2 min & 30 sec)
These videos are to provide SMPs with additional outreach and education materials and efforts for but not limited to PSAs, social  media, and education events. (Winter 2019)
SMP Foundation Manual and training resources will be updated (being developed now)
Additional updates of resources will include kit materials and self-paced training.
Redoing SMP complex interactions manual and training resources (Spring 2020)
Additional updates of resource will include kit materials and self-paced training.

19. Questions?