The government recently announced a billion-dollar health care fraud case. The scam allegedly involved sending Medicare recipients shoulder, knee, ankle, wrist and back braces. In most cases, the patients did not need the braces. In others, the patients never received the braces. The companies would then charge Medicare for the cost of the braces, whether patients received them or not. Ultimately, the government states the scheme resulted in a loss of over one billion dollars.
How did the patients get the braces? Call centers located outside of the country would contact Medicare recipients. The accused would gather information during the phone conversation, have a physician sign off on a prescription and use this information to submit a claim to Medicare.
A recent report by a CBS affiliate claims these initial charges could be just part of a larger, illegal enterprise. The station investigated and found additional patients that appear to have been part of a similar scam. However, the medical device companies discovered during the investigation were not listed in the current indictment. The report predicts the government has yet to release additional charges.
What does this mean for medical device companies? Medical device companies are wise to reevaluate their ordering and billing process. Allegations of improperly billing Medicare can we lead to more than just financial penalties. Depending on the details of the allegations, prison time could be involved.
If your medical device or other company is under investigation by the government it is wise to act to protect your interests. Contact an attorney experienced in health care law issues to discuss your options.
