Hang Up On Durable Medical Equipment Scams
By Mary Johnson, editor
“Hello seniors!” the recorded voice bellows. “Stay on the line to learn how you can get a free Medicare-covered back brace.” I hung up — again. I get this annoying call frequently, but for years now the calls haven’t stopped. They continue despite my protests to the caller, the fact that my landline phone number is listed on the Federal Trade Commission’s “Do Not Call” list, and even reporting the calls to Medicare.
There is no such thing as “FREE” back braces from Medicare. The fact is that this call is not even legal. It’s a scam, and plenty of other phony medical equipment companies are out to steal your Medicare number so they can bilk Medicare with hundreds of thousands of dollars in phony billings. Durable medical equipment plays a major role in the lives of many older Americans, but the program has one of the highest rates of abusive billing, overpricing and out-right fraud.
When you need durable medical equipment, like wheel chairs or breathing equipment for pulmonary disorders, Medicare pays 80% of the approved charge, but only when the equipment has been prescribed by your doctor, and only from Medicare-approved contract suppliers. In an attempt to bring down costs for both the program and beneficiaries, Medicare has made a number of changes in their procedures for coverage of durable medical equipment in recent years, the most important being, to implement competitive bidding.
Recently I had my first glimpse at how another common Medicare billing abuse, double - billing of Medicare, can occur. My doctor prescribed a simple plastic breathing device for a chronic pulmonary condition. I received it by mail. But around the same time, I received a second call from a medical equipment contractor saying they needed to deliver “my order” and wanting to know when they could stop by to show me how to use the device. But my doctor had never mentioned any other equipment or anyone needing to show me how it worked.
I postponed the visit and called my doctor to verify the name of the supplier I should be dealing with. Then I called the original medical device supplier only to learn there was no extra equipment and no one was needed to show me how to use the device. I could learn all I needed to know from the instructions that came with the device and watching a You Tube video online. When the suspect equipment company called again saying the device was ready, I hung up after telling them not to call again.
Do you know how to spot common Durable Medical Equipment Medicare fraud? Here are some common scams:
- Healthcare supplier offers “free” equipment, but bills Medicare, often at inflated prices. The supplier typically asks for your Medicare number and may submit multiple claims for items you did not order.
- Supplier wants you to use their doctors, not yours, who then prescribe unnecessary medical equipment. You may be offered a “free consultation.”
- Anyone who calls or visits you claiming to be from Medicare or the federal government and asks for your Medicare or Social Security number.
- A supplier that bills Medicare for a power wheelchair or scooter when you don’t meet Medicare’s qualifications.
- A supplier that bills Medicare for services you never received or for items for a condition you don’t have.
- A supplier that offers non-medical transportation or housekeeping as a Medicare - approved service. (Neither is covered by Medicare.)
What can you do to stop durable medical equipment fraud?
- Don’t accept any medical equipment unless your doctor has seen you in person and ordered the equipment or supplies on your behalf.
- Never sign a blank form from your healthcare provider or equipment supplier.
- Always read your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB). Look for charges for equipment you did not receive or do not need.
- Refuse and report anything offered for “free” like equipment and supplies, in exchange for your Medicare number.
- Report billing mistakes or possible fraud and abuse. Call 800-477-8477. Learn more online at StopMedicareFraud.gov.
