From the Office of Inspector General (OIG), U.S. Department of
Health & Human Services
Durable Medical Equipment Fraud
Durable medical equipment (DME) companies offer a valuable service by
providing wheelchairs, surgical supplies, catheters and respiratory
nebulizers as well as nutrition and tube feeding supplies and other
health care equipment. However, many fraudulent DME companies have
appeared all across the country.
How the Scam Works
- A fraudulent DME company approaches a fraudulent physician, or uses
an unsuspecting physician’s stolen identity, to medically certify
that a beneficiary needs supplies.
- This same fraudulent DME company may also have stolen, or otherwise
purchased, Medicare beneficiary numbers and begin to fraudulently bill
Medicare for goods.
- Typically no actual equipment is delivered to the beneficiary. He
may not know equipment is being billed in his name but not
delivered.
- In other schemes, a fraudulent DME company may offer the Medicare
beneficiary meals or food in exchange for her Medicare number. The DME
company may also provide the beneficiary with nutritional
supplements. (Be aware that Medicare only pays for nutritional
support when the beneficiary has a feeding tube in place.)
- Other common costly DME items that are offered include
“custom” diabetic shoes, oxygen, nebulizers and therapeutic
mattresses.
- Sometimes the beneficiary is aware of the fraud and is paid a
“kickback” in cash for selling his Medicare
information.
How to Fight Back
- Do not let anyone except your physician’s office handle your
Medicare card. If anyone other than your physician's office requests you
to provide your Medicare information, do not provide it.
- Never accept “free” medical equipment or services in
exchange for your Medicare number. Nothing is ever free.
- Review your Explanation of Benefits paperwork for items that appear
that you did not order or receive and report any discrepancies
immediately.
Report Suspected Fraud
To report suspected fraud, click
here.
