Health Care Fraud Prevention Program Expansion and SMP Capacity Building Grants

Funding Opportunity 1

The HEAT task force has identified geographic areas most vulnerable to Medicare and Medicaid fraud. There is a need to expand the capacity of SMP projects in those areas to reach larger numbers of Medicare beneficiaries, their caregivers and family members with the SMP message of fraud prevention. The goal of this announcement is to enhance SMP efforts to reach beneficiary populations in the geographical locations of the Medicare Strike Forces in collaboration with law enforcement, and other partners such as CMS, community organizations, etc.

Purpose and Objectives
Targeted Requirements for HEAT/High Fraud States

States eligible for this funding opportunity are required to develop innovative, new and targeted strategies for expanding awareness of health care fraud and enhancing the role of the SMP as a working partner in HEAT Strike Force operations.

Funding Opportunity 2

The Centers for Medicare and Medicaid Services (CMS) has identified 18 states with the highest incidences of health care fraud or at the greatest risk of fraud based on such data as greatest numbers of known fraud hot spots, top states with largest numbers of compromised beneficiaries, and those states in the DME Stop-Gap Plan. There is a need to expand the capacity of SMP projects in those areas to reach larger numbers of Medicare beneficiaries, their caregivers and family members with the SMP message of fraud prevention. The goal of this announcement is to enhance SMP efforts to reach beneficiary populations in these designated high fraud states.

Targeted Requirements for High Fraud States

States eligible for this funding opportunity are required to develop innovative, new and targeted strategies for expanding awareness of health care fraud and enhancing the role of the SMP in fraud control.

Funding Opportunity 3

AoA and CMS recognize the need to increase the capacity of all SMP projects to reach larger numbers of Medicare beneficiaries, their caregivers and family members with the SMP message of fraud prevention. The goal of this announcement is to enhance SMP efforts to increase and support the volunteer workforce required to expand outreach and education efforts throughout the state.

Purpose and Objectives
Expansion of SMP Program Capacity

All SMP applicants for this funding opportunity will be required to expand the capacity of the SMP project to recruit, screen, train, manage and support an increased number of SMP volunteers, and utilize these volunteers to effectively expand SMP outreach to beneficiaries in local communities in a more comprehensive manner throughout the state.