Telemedicine services are on the rise, and so are scams directly targeting Medicare beneficiaries. Telemedicine is healthcare provided through telephone or video chat, mainly used to help people in rural communities, or those with mobility issues. With this rise in telemedicine scams, Medicare may have to restrict what kinds of electronic services it provides.
Orthotic brace scams
Scams pedalling orthotic braces to patients who don’t need them is not a new problem. However, the use of telemedicine services to do so is.
In one such scam, a person received a phone call from someone claiming to represent Medicare. He knew it was a scam and hung up. He later received 13 orthotic braces to treat a variety of pains and ailments–none of which he needed. Medicare paid over $4,000 for these braces, all of which were prescribed by four healthcare practitioners who were not in contact with the patient at all.
Ariel Rabinovic works with the Pennsylvania Center for Advocacy for the Rights & Interests of the Elderly. She said the fraud works by fraudsters recruiting dishonest healthcare providers–doctors, nurse practitioners, physician assistants–to contact people they’ve never seen as a patient and hold a fake telemedicine consultation with them.
Rabinovic said, “Sometimes the teledoctors will come on the line and ask real Mickey Mouse questions, stuff like, ‘Do you have any pain?’ But oftentimes, there is no contact between the doctors and the patient before they get the braces. And in almost all of these cases, the person prescribing the brace is somebody the Medicare beneficiaries don’t know.”
Government officials with the Department of Health and Human Services (HHS), Department of Justice (DOJ), and Federal Bureau of Investigation (FBI) have broken up six scams this year alone.
Operation Brace Yourself
In April of 2019, the Department of Justice broke up an international fraud scheme that had cost Medicare as much as $1.2 billion in unnecessary orthotic braces during “Operation Brace Yourself.”
The fraudsters used telemedicine doctors to prescribe unnecessary knee, wrist, back, and shoulder braces. In the end, the DOJ charged 24 people in the crime, including three healthcare professionals and the CEOs of five telemedicine company.
Increasing orthotic brace scams
Between 2013 and 2017, Medicare spending for orthotic braces grew by more than $200 million, according to Kaiser Health News.
During this time, Medicare enrollment grew by 3 percent, but spending on orthotic braces grew by 51%.
Assistant Attorney General of the DOJ Criminal Division, Brian Benczkowski, called the schemes “an expansive and sophisticated fraud to exploit telemedicine technology meant for patients otherwise unable to access health care.”
This is proving problematic for the Centers for Medicare and Medicaid Services (CMS) as health plans across the country are ramping up their use of telemedicine services.
Avoid Medicare scams
Once scammers have your personal information, they may not stop trying to contact you. Do not answer calls from a number you do not recognize. Tell your loved ones to leave a message if they need to reach you from an unrecognized number because you are being targeted by scammers. Save all important phone numbers in your phone.
Remember, Medicare will never call you.
If you are contacted by someone who claims to represent Medicare, hang up and report the call to the Federal Trade Commission (FTC).