It has been reported that Medicare fraud costs taxpayers an estimated $60 billion annually. Having been involved in whistleblower litigation, I am not surprised one bit at that number. In fact, it could be that it’s very conservative. One example of fraudulent conduct was reported last month. It appears that power wheelchairs, which cost the Medicare program hundreds of millions of dollars a year, could be a big problem. Over the course of a several month CBS This Morning investigation, numerous people who have sold and prescribed these wheelchairs told CBS News that the industry bullies doctors, and that Medicare is writing checks that should never be cashed. The SCOOTER Store is the largest supplier of power wheelchairs in the country. It was reported that most Americans have seen its TV ads which reportedly cost the company more than a $100 million each year.
Once a doctor has written a prescription, CBS News was told that Medicare rarely checks whether the chairs are actually necessary. The issue was crystallized when the Department of Health and Human Services Inspector General released a report, which found that industry-wide, 80 percent of Medicare payments for power chairs are made in error. It was also found that most of the chairs were going to folks who don’t need them or lack proof they need them. From 2009-2012, government auditors found The SCOOTER Store overbilled Medicare by as much as $108 million.
Interestingly, the company agreed to give back $19.5 million for chairs it admitted should not have been paid for. It said the amount was less than 4 percent of the Medicare payments it received in the last two years. But according to the Special Committee on Aging, the company only agreed to a repayment after the HHS Inspector General threatened to suspend it from federal health programs. And while The SCOOTER Store disputes the government’s audits, the government found the company owes as much as four times what it’s agreed to repay.
In September, the government launched a pilot program to address the issue. It requires Medicare to approve chairs before they are paid for. But it appears that the same companies – with the high error rates – were hired to run it, processing payments to suppliers from the government.
This report on one company illustrates that we need to get tougher on fraud in government programs and protect taxpayer dollars. Corporations participating in government programs must be held accountable. We can’t tolerate cheating on programs such as Medicare and Medicaid. Taxpayers must be protected when companies abuse the system.
Source: Corporate Crime Reporter
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