Durable Medical Equipment Fraud

Florida DME Fraud Lawyer

Stopping Durable Medical Equipment Schemes

Fraud involving wheelchairs, walkers, crutches, oxygen equipment, hospital beds and other types of durable medical equipment (DME) is more common than most people might think. Medicare Part B (medical insurance) covers medically necessary DME that is prescribed by a physician for use in a patient’s home. The term “durable” generally refers to medical equipment that can withstand repeated use and has an expected life of three years or more. According to a recent article in the AARP Bulletin, every year the government’s Medicare insurance program loses roughly $1,000 per member as result of theft or waste, and the total dollars lost to Medicare fraud in 2017 was estimated to be $60 billion. A significant portion of the government’s losses are attributable to DME fraud and waste.

While the government has long acknowledged the gravity of the problem and taken aggressive steps to combat it, the reality is that fraudsters continue to cheat the system with new schemes popping up in Florida and all over the country. If you suspect durable medical equipment fraud and would like to do something about it, it is important to work with the right attorney. These cases involve complex legal and financial concepts and are best handled by an experienced Florida DME fraud lawyer. At The Florida Law Group, our attorneys know how these cases work, and we will help make certain that you are taking the appropriate steps to combat these unethical and illegal activities.

What is Durable Medical Equipment Fraud?

Durable medical equipment (DME) fraud can take many different forms. Some of the more common types of DME scams used to defraud the government include:

• Billing for DME that is not medically necessary
• Billing for DME that was not prescribed by the doctor treating the patient
• Forging a physician’s signature on documents
• Billing for DME that was never provided
• Failing to give credit for DME that was returned
• Billing for duplicate DME orders
• Stealing a beneficiaries’ identification numbers to submit false claims
• “Upcoding” or billing for more expensive equipment than the actual items provided to the patient
• Paying kickbacks to gain referrals for DME or engaging in improper financial arrangements with referring physicians (activities which are in violation of the Anti-Kickback Statute or Stark Statute)

These are just a few of the DME schemes that criminals use to steal from the Medicare/Medicaid system and private insurance companies. If you have reason to believe that DME fraud has occurred or is currently occurring, you can take steps to report the fraud. The False Claims Act provides a legal avenue for individuals to come forward and blow the whistle on fraud against the United States. Under the Act, individuals who have knowledge of DME fraud can file a lawsuit on behalf of the government as a qui tam whistleblower. If the government decides to join in the medical qui tam action, the whistleblower will be eligible to collect a portion of the recovery (15-25 percent), and he or she will receive protection from retaliation by employers.

Have Reason to Suspect a DME Scam? Discuss Your Situation with a DME Fraud Attorney

If you have evidence of a durable medical equipment scam or any other type of healthcare fraud, you should speak with a whistleblower attorney at The Florida Law Group. Our legal team can explain your options and walk you through every step of the legal process. Call us today at (833) 899-0310 to schedule your free confidential case review with a Florida DME fraud lawyer.