Feds Shut Down $1.2 Billion Medicare Scheme — Finally

Feds Shut Down $1.2 Billion Medicare Scheme — Finally

By Mary Johnson, editor

For years I’ve been getting the same unwanted robo call.  “Hello seniors!” a voice bellows.  “Stand by to learn how you can receive a free back brace covered by Medicare.”

This call is a scam.

One can’t write about Medicare as I do without learning that Medicare has requirements for everything.  Lots of requirements.  Nothing is free.  Not even the services that Medicare says are free.  In the case of durable medical equipment like back braces, Medicare requires a doctor’s prescription for coverage.  For a prescription, you must be seen by a doctor who participates in Medicare and you must have a medical condition for which a back brace is medically necessary.

Getting back to the scam call.  There is nothing wrong with my back.  I can still lift a 40 pound bucket of kitty litter without any help.

Even more importantly, you first must be covered by Medicare to begin with.  At the time I started getting the calls, I was not.  I called and reported the fraud to Medicare.  But that made me feel like banging my head on my desk.  The person I spoke with told me that they were getting a lot of calls about back brace telemarketers and that they were “looking into it.”  The calls continued.

Now finally, after what seems like a decade of aggravating calls, Federal officials recently announced that they had shut down the alleged telemedicine scam pedaling unnecessary medical braces.  Happy day!

The U.S. Department of Justice says this is one of the largest Medicare schemes ever investigated by the F.B.I, charging 24 people in a $1.2 billion alleged scam.  As part of the complicated operation, doctors got kickbacks for prescribing unneeded back, shoulder, wrist and knee braces to Medicare recipients.  The defendants paid doctors for prescriptions, which they in turn sold to durable medical equipment companies, which in turn charged Medicare for the medical braces.  Those participating in the alleged scheme laundered money through shell companies and used the proceeds to buy exotic automobiles, yachts and luxury real estate in the U.S. and abroad.

Medicare fraud costs everyone.  The alleged $1.2 billion that fraudsters got from Medicare adds costs to our Part B premiums and increases the need for more revenues, including from older Americans who pay taxes on up to 85% of their Social Security benefits.  $1.2 billion spread over 60 million Medicare beneficiaries could potentially add an extra $1.70 per month ($20.40 for the year) in higher premiums for each and every one of us next year — and even that may be more than many of our readers can afford.

From the beginning, The Senior Citizens League has supported strengthening the antifraud measures for Medicare, but since the 2011 budget battles, Medicare has been subject to crippling budget cuts that reduce funding for fighting fraud.  Let’s encourage today’s Congress to build on this success— otherwise shutting down this back brace scheme could be just a one-time fluke.

How to report Medicare fraud

Call 1-800-MEDICARE (1-800-633-4227).

Report it online to the Office of the Inspector General.

Call the Office of the Inspector General at 1‑800‑HHS‑TIPS (1‑800‑447‑8477). TTY: 1‑800‑377‑4950.