Medical Equipment Fraud
As we’ve seen in a previous article, a lot of people require more assistance when it comes to getting around or participating in activities of daily living. We also already know that there are people out there who would enjoy nothing better than to take advantage of these older folks through various forms of fraud. One such type—Medical Equipment Fraud—is going to be the focus of this article. So let’s get started.
The first thing to talk about is how prevalent the problem of durable medical equipment fraud really is. Back in 2009, Medicare spent over $10 billion on durable medical equipment. Sadly, over half of that money was spent improperly—this means that the equipment was totally unnecessary or the bill was altogether wrong. The next thing we need to know is what durable medical equipment is exactly. Let’s take a look.
What is Durable Medical Equipment?
Durable Medical Equipment (DME) is defined as any medical equipment prescribed by your doctor that is reusable. It can include things like hospital beds, walkers, wheelchairs, home oxygen equipment, scooters and prosthetics. Also, Medicare will only cover durable medical equipment if you receive it from a supplier that is enrolled in the Medicare program.
Now let’s see some examples of Durable Medical Equipment fraud:
- Suppliers who offer “free” equipment but send Medicare a bill.
- Those who want you to use their doctors (who will then give you a prescription for unnecessary medical equipment).
- Doctors who supplies who give you medical equipment you never even needed or requested, or charge you for items you don’t ever receive.
- Companies that bill for duplicate orders.
- Suppliers who bill Medicare for people who have passed away.
- Those suppliers who deliver a generic or off-the-shelf product, but send Medicare a bill for a costlier product.
- Older individuals who willing accept any unnecessary equipment or supplies, or allow their Medicare number to be used in order to receive money or other things.
So how can you protect both yourself and Medicare from experiencing DME fraud? Be sure to do the following:
- Always read your Medicare Summary Notice (MSN) or the Explanation of Benefits (EOB) to see if there are any charges for equipment you don’t need or did not receive.
- Be sure to treat and protect your Medicare, Medicaid, and Social Security Card just like you would a credit card.
- Be aware that Medicare medical suppliers cannot make any unsolicited phone calls or send emails to see you any equipment unless you have done business with them in the last 15 months.
- Never sign any blank forms from your health care provider or equipment supplier.
- Be sure to both refuse and report anyone who is offering “free” equipment, supplies, or services in exchange for getting your Medicare number.
- If you need to rent and return equipment, be sure that you obtain a dated receipt.
- Report any concerns and questions you have about billing mistakes or any possible fraud and abuse to Medicare or local Senior Medicare Patrol (SMP).