Feds Bust a $1.2 Billion Medicare DME Scam Targeting Seniors

Earlier this week, the authorities announced charges against 24 people across the U.S., including doctors accused of writing bogus prescriptions for “durable medical equipment" (DME), such as unneeded back, shoulder, wrist, and knee braces. Others charged included owners of call centers, telemedicine firms, and medical equipment companies.

This is being called one of the largest health care fraud schemes investigated by the FBI and the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG). According to allegations in court documents, some of the defendants obtained patients for the scheme by using an international call center that advertised to Medicare beneficiaries and “up-sold” the beneficiaries to get them to accept numerous “free or low-cost” DME braces, regardless of medical necessity. The international call center allegedly paid illegal kickbacks and bribes to telemedicine companies, doctors, or nurse practitioners, to obtain DME orders for these Medicare beneficiaries without ever even speaking to them. Finally, the orders were then sold to DME companies, who shipped out box after box of braces, fraudulently billed Medicare or other insurance programs for every item. People all over the country have been receiving boxes of braces they did not need or want. And often, they are responsible for a copayment on these items, for hundreds or even thousands of dollars! Collectively, the CEOs, COOs, executives, business owners and medical professionals involved in the conspiracy are accused of causing over $1 billion in loss to Medicare.

Thanks to the FBI, HHS-OIG, and the Department of Justice these criminals are facing indictments. But this is just the tip of the iceberg, as seniors all over the country are receiving unrequested and unnecessary DME from hundreds of providers, on orders written by hundreds of medical practitioners who have never interacted with the patients. Bracker & Marcus LLC has experience with these types of matters. If you or a loved one have received DME that you did not ask for and do not need, contact us for help.