SCAMS BULLETIN Host Jay White is a volunteer attorney who provides free legal services for low income seniors in San Mateo County, California.

December 22, 2019

MEDICAL EQUIPMENT SCAMS

Wheelchairs, walkers, braces and other devices prescribed by doctors are vital to help patients deal with an injury or chronic illness at home. US Medicare spends more than $6 billion a year on durable medical equipment for that purpose. That’s a boon to beneficiaries, but also a big draw for fraudsters who exploit older Americans’ health care concerns.

In a medical equipment scam, someone may reach out to you with an offer of a “free” (as in, “Medicare will pay for it”) brace, wheelchair or other device. You might get an unsolicited phone call, see an advertisement or be approached at a health fair or similar event.

Sometimes, it’s a garden-variety government impostor scam: Someone claiming to be from Medicare calls to say you’re eligible for a free knee or back brace, and they need your Medicare or Social Security number to process the benefit. If you fall for it, you may or may not get a brace, but the crooks get what they need to steal your identity.

Medicare fraud involves unscrupulous equipment suppliers ripping off Medicare on a grand scale, using telemarketing and hard-sell tactics. They lure you into ordering their wares, get your health care information, obtain bogus prescriptions (by paying kickbacks and bribes to doctors or by forging their signatures) and file false claims. They stick Medicare with the bill for costly devices that are not medically necessary, not properly prescribed or not delivered to patients at all. (DME fraud might also target Medicaid or private insurance companies.)

Watch out for the fraudsters who target you to help them defraud Medicare. Don’t let your health concerns make you an unwitting accomplice to fraud.

Watch for these warning signs:

*You receive an unsolicited call or other communication offering a free or low-cost medical device as a Medicare “benefit.”

*Someone claiming to be from Medicare asks for your Medicare or Social Security number. Medicare representatives almost never make unsolicited calls to consumers and do not ask for personal information by phone.

*Your quarterly Medicare Summary Notice (MSN) or an explanation of benefits (EOB) from your health plan lists medical equipment you did not order or receive.

Do’s:

Do hang up on unsolicited calls offering you a medical device that will be billed to Medicare.

Do carefully review MSNs and EOBs. Call Medicare (800-633-4227) or your insurance company if you see claims for supplies or services you don’t recognize.

Do be aware that if you accept an offer of medical equipment, you could be responsible for up to 20 percent of the Medicare-approved cost of the item.

Don’ts:

Don’t give your Medicare or insurance number to strangers. Share it only with trusted health care providers.

Don’t order durable medical equipment over the phone unless advised to do so by your physician.

Don’t accept delivery of medical equipment unless it was ordered by your doctor.

Don’t be swayed by scare tactics, such as claims by an equipment provider that you should get a device now because Medicare is running out of money. Charging Medicare for equipment for future use, before your doctor certifies it as medically necessary, is illegal.

AARP’s Fraud Watch Network can help you spot and avoid scams. Sign up for free “watchdog alerts,” review the scam-tracking map, or call the toll-free fraud helpline 877-908-3360 if you or a loved one suspect you’ve been a victim.Attribution: AARP