Yes, you. You know who you are. You are the durable medical equipment providers whose apparent only goal is to scam Medicare.
It started withe the commercials. “If you have Medicare, you may be eligible for a pain-relieving knee or back brace at little to no cost. Call now.”
Unsatisfied with the response, you began to troll the nursing homes, looking for willing victims. Again, you promise “pain-relieving” knee or back braces and even heating pads. Who wouldn’t want a free heating pad? Who doesn’t have occasional back pain?
Well, Medicare has been cracking down and now requires a detailed evaluation from the physician before they will authorize the supplies. That’s no worry to you, though, you just tell your patient, “We’ll take care of everything. We’ll send all the forms to your doctor.” They then bombard said doctor with the Medicare-required request forms.
Should said doctor fill out the forms in a way that will not allow you to get your maximum reimbursement, there are no worries. You will simply instruct the physician in how to fill out the forms. If the physician notes (correctly) that the patient actually can walk without support, well, you just send the form back to them with instructions that she “needs” to document that the patient cannot walk without assistance (whether or not that is true).
But that wasn’t enough. Apparently, patients are too ethical to volunteer for your schemes. So now you have taken it further. While my patient was on the telephone with you trying to get diabetic supplies, you informed him that he was eligible for a “pain-relieving knee brace”. When he told you that he didn’t want or need a brace, you persisted in harassing him until according to him, he allowed you to order it to get you to stop bothering him, at which time you then began to suggest he needed a back brace.
This explains why I have been getting daily requests for Medicare justification for the braces that I haven’t ordered. Since the patient was going to be seen within a week, I held onto them, but you made sure to send a new request at least daily, even after I sent it back with a note to stop sending them.
All I had to ask the patient was “I see that you were requesting a knee brace-are you having pain?” for him to come out with the entire story. This is actually not the first time this has happened. I have called Medicare patients before when I got the requests and been told that they really didn’t want anything but were being pressured to agree.
So screw you for preying on elderly people to try to scam Medicare and for causing a ton of work for the already overworked primary care doctors. I have started to tell my patients to call Medicare and tell them what you are doing and I hope you get charged with Medicare fraud. And incidentally, not only do these braces not relieve pain, but they often cause additional muscle atrophy if used too long. I’ll treat my patients with physical therapy and appropriate medications, if you don’t mind, and keep them mobile and strong as long as possible.