Community Chat

[Dragonflyveb]

Medicare scammers are at it again!

A couple years ago, they used my number to bill Medicare for $6k worth of catheters. Not mine...

Just checked my EOBs and found $6k of back, wrist, and knee braces. Not mine either...

I called Medicare--they are very nice to deal with. Seems like durable medical equipment is a popular target. Usually around $6k, so nobody gets suspicious.

I never give out my number except to medical, and never answer the phone. But medical data services get hacked, so the moral of this story is--check those EOBs online. It would be nice if we got them as visits occur, but MC doesn't do that, so here we are.

dragonfly

[wagirl]

will add that to my daily list of accounts to check. good info!!

[millieshops]

Scammers are busy, and they follow the money wherever it can be found. Some live in the US, but even more work outside our borders.  

[ellaphant]

I had two charges of $800 ...called Medicare...they're aware. A group was just arrested for Billion$ in fraud ...they're from over seas

[MorningLover]

June 30 

Health Care Fraud Takedown

The U.S. DOJ announced a major health care fraud takedown, charging 324 individuals with participating in schemes involving over $14.6 billion in intended losses. 

This operation is the largest health care fraud takedown in U.S. history. The takedown involved federal and state law enforcement agencies and targeted schemes that exploited patients and taxpayer.

-The takedown involved 324 defendants, including doctors, pharmacists, and other licensed medical professionals. 

-The schemes involved over $14.6 billion in intended losses.

-The schemes involved a wide range of fraudulent activities, including billing for unnecessary services, falsifying diagnoses, and illegally diverting controlled substances.

-The DOJ emphasized that the schemes targeted vulnerable populations, including the elderly and disabled.

-Law enforcement seized over $245 million in cash, luxury vehicles, and other assets as prosecutors warned of a growing push by transnational criminal networks to exploit the U.S. health care system. 

Among the cases is a $10 billion urinary catheter scheme that authorities say highlights the increasingly sophisticated methods used by transnational criminal organizations.

Authorities say the group behind the scheme used foreign straw owners to secretly buy up dozens of medical supply companies and then used stolen identities and confidential health data to file fake Medicare.

[colleena]

@MorningLover  I was involved in the catheter fraud and what I found interesting is my supplement says if Medicare pays then they pay, so I asked how does Medicare, my supplement & me get our monies back & they didnt seem concerned.   

[Mz iMac]

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@Dragonflyveb wrote:

Medicare scammers are at it again!

I never give out my number except to medical, and never answer the phone. But medical data services get hacked, so the moral of this story is--check those EOBs online.

dragonfly

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@Dragonflyveb  Most of the fraud/scam(s) are from within the medical offices not online.

[Still Raining]

If nothing else, checking your monthly statements will rise your eyebrows.  The details and charges by item are funny.  Not in a good way.

It is also a good audit to check a detailed bill for an IP stay.  They often have errors.

We are the first line of defense for medical audits.

[bargainsgirl]

Medical scammers cause great hardship to those who really need it.  Now those in true need will suffer because of the crackdown on frauds.  They need to find a way to stop the frauds without hurting the majority!!!

[Zaimee]

@Dragonflyveb   Excellent advice to check EOB. 

Scammers put in claims for DME Durable Medical Equiptment for $36,000 of medical bandages for 2 days of surgery that I didn't have!!!!

I contacted both Medicare Fraud and my supplement fraud dept. I also researched the companies name, address, doctor . Doctor was a real person but head of dept, not performing surgery. They used his name. Address was in a warehouse district in Miami; probably a room with a desk and phone! 

Medicare Fraud and supplemental did not pay claim. They said Miami is headquarters for this type of fraud. I'm sure my info was stolen from major facility that I had been to. I told them I'm a small person and that amount of bandages would have mummified me!