Medicare spends billions of dollars a year on durable medical equipment (DME) — wheelchairs, walkers, braces and other devices prescribed by doctors to help patients deal with an injury or chronic illness at home. That’s a boon to beneficiaries but also a big draw for fraudsters, who exploit older Americans’ health care concerns to enrich themselves.
In a medical equipment scam, someone reaches out to you with an offer of a “free” (as in, “Medicare will pay for it”) brace, wheelchair or other device. You might get an unsolicited phone call, see an advertisement or be approached at a health fair or similar event.
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Sometimes, it’s a garden-variety government impostor scam: Someone claiming to be from Medicare calls to say you’re eligible for a free knee or back brace, and they need your Medicare or Social Security number to process the benefit. You may or may not get a brace, but the crooks get what they need to steal your identity.
Those cons victimize individual consumers. The big business in DME fraud involves unscrupulous equipment suppliers ripping off Medicare on a grand scale.
Using telemarketing and hard-sell tactics, these operators lure you into ordering their wares, get your health care information, obtain bogus prescriptions (by paying kickbacks and bribes to doctors, or by forging their signatures), and file false claims. They stick Medicare with the bill for costly devices that are not medically necessary, not properly prescribed or not delivered to patients at all. (DME fraud might also target Medicaid or private insurance companies.)
And a big business it is. In December 2021, the owners of two Texas DME companies were sentenced to more than 12 years in prison for their roles in a kickback conspiracy to generate false claims that federal prosecutors said cost Medicare $27 million. The case was part of a massive federal crackdown in 2019 that netted 24 arrests and uncovered Medicare losses of more than $1.2 billion. These and other costs related to DME fraud are borne by the taxpayers who fund Medicare and by beneficiaries shouldering higher premiums and out-of-pocket costs.
Don’t let your health concerns make you an unwitting accomplice to fraud. Take these steps to avoid medical equipment scams.
- You receive an unsolicited call or other communication offering a free or low-cost medical device as a Medicare “benefit.”
- Someone claiming to be from Medicare asks for your Medicare or Social Security number. Medicare representatives almost never make unsolicited calls to consumers and do not ask for personal information by phone.
- Your quarterly Medicare Summary Notice (MSN) or an explanation of benefits (EOB) from your health plan lists medical equipment you did not order or receive.
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