Alert
Close

Think you know AARP? What you don't know about us may surprise you. Discover all the 'Real Possibilities'

HIGHLIGHTS

Open
America's Winter Escapes Sweepstakes
Introducing RealPad by AARP
You and Your Town Contest-You could win an AARP RealPad

AUTO BUYING PROGRAM

AARP Auto Buying Program

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Safe Driving in 2014 Sweepstakes

Learn how AARP Driver Safety can help you stay safe—and enter for a chance to win $1,000. See official rules. 

Download the ipad App

AARP-iPad-ePub-app

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

AARP Books

Medicare for Dummies book cover

Get the answers you need, from Patricia Barry, AARP's Ask Ms. Medicare

Most Popular

Viewed

share your Thoughts

Reader stories help us fine-tune our education efforts and strengthen our calls for action on issues that matter most to you. We read and learn from every story and may use yours (with permission) to brief legislators, inspire other readers and more. Please share your story with us. Do

Health Care Fraud and You

Protect Yourself From Durable Medical Equipment Fraud

Durable medical equipment fraud is one of the leading ways criminals commit health care fraud. They do so by filing false insurance claims with Medicare or your insurance company.

Durable medical equipment, such as wheelchairs, scooters, walkers and oxygen supplies, are prescribed for you by your doctor. Nebulizers, incontinence supplies, orthotics, prosthetics and hospital beds for use at home are also considered durable medical equipment.

Examples of durable medical equipment scams include:

• Shipping medical equipment to patients before their doctor provides a prescription or the required Certificate of Medical Necessity.

• Billing for duplicate orders.

• Deliberately shipping more than the amount ordered or what is reasonably necessary.

• Billing for more expensive items than those that are shipped.              

• Failing to give credit for an item that is returned.

• Forging documents that can only be signed by a doctor.

• Stealing insurance identification numbers to use for false claims.

• Paying patients and physicians to submit fraudulent claims.

• Billing all residents in a nursing home, as if everyone in the home needed and received the equipment.

Ways you can protect yourself from durable medical equipment fraud:

• It's illegal for a medical supplier to make unsolicited telephone calls to people with Medicare. The exceptions are if you have given written consent to have the supplier call you, the call is about an item the supplier already provided to you, or the supplier has delivered equipment to you in the previous 15 months. Also, a supplier may call you to confirm delivery and billing information for a new item if you know that your doctor is contacting the supplier on your behalf.

• Suppliers cannot get around the phone call ban by hiring an independent marketing firm. Medicare will not pay claims from suppliers who make unsolicited, illegal telephone calls to Medicare beneficiaries.

What you can do:

• Always review your Medicare Summary Notice (MSN) or insurance Explanation of Benefits (EOB)  for mistakes. If you see any charges for durable medical equipment that you do not need or did not receive, report it as suspected fraud. You can get help understanding what’s in your MSN at our MSN decoders.

• Similarly, if you receive an unsolicited call to buy medical equipment your doctor has not ordered, speak up.

• Report questionable charges or sales pitches to: Medicare.gov, 800-633-4227 (800-MEDICARE), TTY: 877-486-2049.

• If you have private insurance, report suspected fraud to your insurance company's anti-fraud department. You should find a number to report fraud on your insurance Explanation of Benefits. You may also want to contact your state insurance department.

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Reading eyeglasses eyemed 6 membership benefit health

Members save 25% on orders of $200 or more and get 25% off lens upgrades at glasses.com.

AARP/Walgreens Wellness Bus Stops in Clarksdale, MS

Members can get exclusive points offers from Walgreens and Duane Reade.

Member Benefits

Join or renew today! AARP members receive exclusive member benefits & affect social change.

Rewards for Good

Your Points Balance:

Learn More

Earn points for completing free online activities designed to enrich your life.

Find more ways to earn points

Redeem your points to save on merchandise, travel, and more.

Find more ways to redeem points