Friday, July 4, 2008

Home Medical Equipment, Often a Scam--Look Out

--Con Artists Shine in the Art of Forcing Unneeded Home Medical Equipment on Medicare Recipients

"It's free. Medicare pays for it."

This is the hue and cry commonly fed to senior citizens--Medicare participants--by medical equipment manufacturers, their sales personnel, and by con artists. A wide range of in-house installations are covered--from oxygen units to various respiratory and other vital organs servicing devices. If your yawn is so wide that your cavities can be counted, be aware that a dentist somewhere will quickly step in, drilling and filling. Medical equipment fraud is a good example

For those who think you get Holy Water by boiling the hell out of it, the medical equipment boys frequently provide a good object lesson.

The appeal is so simple that it's hard to deny. All you need do is cough up your Medicare number and get your Doctor to sign a form certifying that the equipment is needed. This is most often easy to do. The physician justifies authorization on the grounds (to himself): Can't hurt; might help. With the con artist, they usually simply shortcut the whole routine by merely faking the signatures or bribing corrupt doctors to sign the forms. Once everything is in place the providers bill Medicare for services or merchandise not needed--and were not ordered through proper channeling.

As that renowned vendor of sage wisdom, Yogi Berra, said--you've got to be very careful if you don't know where you're going because you might not get there--it's best to hold back, show some restraint, before signing up. Here are some check points to protect you from these fleece jobs.

< Practicing better living through denial is better than freely giving personal information away. Give your insurance / Medicare identification only to those who have provided you with medical services.

< Don't get into a situation like 2 monkeys fighting over a lone banana. Know if your physician has ordered equipment for you. If in doubt, ask, in so many words.

< Keep full, complete records. Where deceit and humbug rein, you've got to have black and white documentation of everything.

< Don't let the choice become: Which is it? Are you a slow learner or a quick forgetter? This is a situation that could be dangerous. So, do not do business with door-to-door or telephone salespeople who tell you that use of medical equipment is free.

Little realized is that, frequently, the "beneficiaries" of the special home, medical equipment treatment are indicted right along with the con artist propagators. If the men in the white coats adorn you with a straightjacket--because you let yourself drift into fraud, and started beating your head against a wall when accused--you can be certain this is not a piece of medical equipment designed for use at home. Too late. For sure, you are about to be "hauled off."

40 comments:

Robin Easton said...

Those last to paragraphs had me in stitches. You are such a witty writer. I can not believe the scams out there. This is wild stuff!!! And when I think about the number of scams and the amount of fraud that gets carried out....I then start to ask myself how MANY gullible people are THERE??? The number must be fairly high of these jokers wouldn't have a "market" or incentive to continue with their cons. That is a rather alarming thought. LOL :0 :) Great post Jack. Just wonderful writing.

Gene Kranik said...

I read something like this and I can only think, if it's so easy to commit Medicare fraud, how can the government possibly run a national health care system properly, with protections against fraud? They seem to be institutionally incapable of running anything properly.

Henry S said...

Its sad but I have to agree with Gene. I have thought that a national health care system is needed, but after I see this I have to wonder about how the government would ever be able to manage it. The record of other countries has a lot of bad along with the good.

Terry said...

I like, better living through denial. That's got to be the best line in this piece, Jack.

Jack Payne said...

Robin, I almost choke on this stuff. All these stories are far too frequent. Why? Because there are so many gullible people out there who fall for these scams.

Jack Payne said...

Gene and Henry, ditto. My thinking, all the way.

Warmer said...

For those who think you get holy water by boiling the hell out of it. That's my line.

Swubird said...

Con Man:

Excellent post. Very informative. I don't know much about this whole Medicare fraud business except that there is a lot of it going on. It's a tragedy this things have to be this way.

A friend of mine needed some kind of back brace,and he decided to shop around before purchasing it. On place asked if he was paying out of his own pocket, or was it being paid my Medicare. It would cost him about $100, but Medicare would pay several times more than that. Sad.

Happy trails.

Dolcett said...

My mother has been gone after with this pitch many times. She tells me they always repeat it's free, it's free, Medicare pays, over and over again. It is absolutely revolting how easy it is.

Jack Payne said...

Yeah, Swu, I've heard many a story about the 2-tier pay system too. Do it one way--out of your own pocket--and the price is X dollars. Do it by letting Medicare pay, and the price is XXX dollars. Disgusting.

Jack Payne said...

Yes, Dolcett. It's amazing, how loud they can yell this, isn't it?

Terry said...

I don't like this topic, Jack. When are you going to move on to something else? Its not you, its the memories this brings back. A good friend's father got in a lot of trouble by gloming onto every free medical device he could. It took a sharp attorney a lot of haggling with the Feds to get him off the hook.

Ione Hesber said...

Hope the men in the white coats don't come after me. In the past I have taken on such free services.
No more. Now caution is the operable word.

Jack Payne said...

Terry and Ione:

There are lots of cases of innocent people getting dragged into this scam, kicking and screaming. At the time they didn't realize it, but they were participating in a conspiracy. Or, as the formal charges of being a "co-conspirator" appear to imply. Caution must be the operative word--before committing to these "freebie." services.

Joe Tennison said...

I've heard these situations are dangerous as the Government does not know whether you are part of the scam. Watch out.

Pentad said...

Preying on the elderly gets my blood boiling! Grrr.

Anonymous said...

Would love to talk with you about a con artist I would like to expose. I am wife number 3.... He's quite a made for TV movie of events. Immigration, women, money abusiveness, and lots of drama.

To protect my safety this is anonymous as there is still too much going on.

NEED to talk with you though as legal matter with him are still ongoing.

When the money ran out.....

Please let me know how to find you

Anonymous said...

Isn't it just a shame that people here in America get taken in by hogwash starting at the top and it just trickles down and is shoveled under the rug.
Shame on you know who you are.

Anonymous said...

Isn't it just a shame that the people here in America aren't aware of what is really going on!
Starting at the top to the very bottom. Come on people be your own advocate stop listening to all of the garbage.

WAKE UP AND SMELL THE ROSES AND READ SOMETHING REAL!

Anonymous said...

I am a Medicaid Fraud Investigator, so I found your comments interesting. To blame this problem on our government is wrong. There would be no fraud without the criminals - doctors, dentists, clinics, pharmacies, home health agencies and durable medical equipment supply companies. THEY are the one's perpetrating a crime. Yes, educated, professionals, who could earn a great living in their own right, deliberately scam the taxpayers. Hard to believe?

James Yaksten said...

I must blame the government for the problems in home medical equipment scams. As a supplier of home medical equipment, we are constantly hit with government changes that are an attempt to fight fraud. These changes cost us major dollars each year but the net result is that fraud continues. I blame this on the complexity of Medicare laws in which Medicare themselves cannot interpret or explain. I attend every educational webinar Medicare hosts and at the end of each one where Q&A session. In 90% of the webinars, Medicare responds to questions with "we are uncertain and will have to post answer to your question later on." These complex laws lead to many "gray" areas that bad suppliers take advantage of. In addition, people with Medicare don't know what is fraud and what is not so they can't report it. That's why more simple rules must be made so that when a bad supplier attempts to pull one over a person with Medicare, they can say "Not today, cause I will report you." Second, Medicare has created accrediation to prevent fraud hoping that all suppliers will follow golden rules set forth by Medicare. Even though Medicare hired and trained 11 companies to accredit all suppliers, these accrediation companies are a joke. Companies with big money are given advance warnings for their surprise inpection, many surveyers never walk into the doors of some of these companies, and they never have to follow Medicare's golden rules. Plus, Medicare has exempted over half the professions from the accrediation process so the legitimacy of accreditation is null. Thirdly, Medicare is now requiring suppliers to purcahse surety bonds as a measure to fight fraud. Again, there are the exempted professions who do not have to carry surety bonds. I do not know the answers to fraud in Medicare but I am smart enough to know in order to accomplish a goal, everyone must be on board and everyone must be given the same rules to follow in order for it to work. There should not be any exemptions from the rules. I feel that as a provider, I know the rules, I know what is right, and I know how I would want my parents to be treated. Therefore, every time a see, smell, or hear of fraud, I pick up the phone and make a call to the fraud hotline. I would like to end on a couple of examples of fraud in Medicare. First as a supplier, you cannot advertise that Medicare will cover an item 100% and you cannot advertise you will require a patient to pay copays. Even a fifth grader can do an internet search and find 1000's of companys doing this online. Why can't the government do this and try to stop fraud?

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