John Ernest received a call one night last winter inquiring whether or not his father, Dean, who was living in a nursing home at the time, was experiencing any back pain. The person on the other end of the line, claiming he was calling on behalf of Medicare, offered John’s dad a free orthotic brace.
Suspecting the caller to be a fraud, John declined and hung up the phone immediately. Although he never gave out his father’s Medicare information, approximately 13 different medical braces showed up on his doorstep shortly after. What in the world was going on?
In the case of John and Dean Ernest, Medicare ended up spending $4,000 for 10 of the 13 braces sent to them. The braces came from 4 separate medical equipment companies and were ordered by different health care professionals.
The interesting thing is that these orthotic braces can only be ordered with a prescription. John Ernest mentioned that he never talked with a health professional on the phone, only someone that said they were representing Medicare. How is this possible?
Ariel Rabinovic, a representative that works for Pennsylvania’s Center for Advocacy for the Rights & Interests of the Elderly, said that scam artists recruit health care professionals and ask them to contact individuals that are not their clients and pose as telemedicine consultants.
It turns out that Willie McNeal, a Florida man who owns and operates two of the fraudulent telemedicine companies—WebDoctors Plus and Integrated Support Plus—hired another doctor to write prescriptions for braces.
McNeal received Medicare beneficiaries’ information from telemarketers. Once his hired health professional wrote prescriptions for the patients, he would send the prescriptions back to the telemarketing companies in exchange for payments.
The telemarketing companies would then sell the prescriptions to medical equipment providers, who shipped the requested supplies to the patient and bill Medicare. It’s a very elaborate scheme that is gaining traction.
Assistant Attorney General of the DOJ’s Criminal Division Brian Benczkowski said that these scams are “an expansive and sophisticated fraud to exploit telemedicine technology meant for patients otherwise unable to access health care.”
Unfortunately, there isn’t too much that Medicare beneficiaries can do to protect themselves from the rise of these scams. These scammers are taking advantage of the medical equipment field and Medicare, not necessarily the patients themselves.
However, if you feel that you received a call from someone posing as a telemedicine representative or consultant, contact a lawyer immediately. The more beneficiaries that report fraudulent behavior, the quicker these scams can be thwarted.
If telemedicine scams continue to increase, Medicare beneficiaries and even those who possess private health insurance will notice a huge impact on their wallets. The US taxpayers are the ones that fund Medicare, after all. If unnecessary funds are being spent on medical equipment that wasn’t requested, healthcare premiums and out-of-pocket costs are going to skyrocket.