Federal Government Cracks Down on Medicare Fraud for Durable Medical Equipment
For years, the federal government has warned senior citizens to be cautious of advertisements that promised Medicare would pay for certain medical equipment. This is because so many companies try to sell seniors medical equipment that they don’t need. After a federal government crackdown, however, Medicare administrators are still being chided for misleading the public about how hard they’ve worked to eliminate billions of dollars in fraud.
Fraud problems persist, often from well known medical equipment suppliers who sell scooters or power wheelchairs, known as durable medical equipment. Because so many seniors are convinced by the advertised promises of these companies, who claim that Medicare will pay for medical equipment.
In some extreme fraud cases, after consumers had already agreed to the medical equipment, it was never delivered, or the wrong equipment arrived. Even in these cases, Medicare was falsely billed.
Attorneys have even coined the phrase “scooter fraud†for power wheelchair providers who use unscrupulous tactics to create a market for their products. Many times, Medicare is billed for a power wheelchair when a much less expensive scooter is provided. Government lawyers involved in these cases have alleged that the companies would bill Medicare, Medicaid or insurers for the power wheelchairs, which are double the cost of scooters. Then, they would collect millions in profits.
Recently, the Justice Department has begun an effort to combat Medicare fraud, known as the Health Care Fraud Prevention and Enforcement Action Team (HEAT). As a protection against fraud, durable medical equipment suppliers must complete a form that certifies the medical necessity of the equipment. Part of the form can only be completed by a doctor, but some medical equipment companies still hire their own doctors to help with the forms before submitting them on behalf of beneficiaries.
Even though Medicare pays for 80 percent of most medical equipment (with the remaining 20 percent being paid by a supplemental insurer or Medicaid), consumers should be cautious of any company that tries to offer them equipment they don’t need. It is safe to assume that when this is happening, the company is more concerned about billing Medicare than they are with the customer’s healthcare.