Durable medical equipment covers everything from crutches to wheel
chairs. There are literally hundreds of thousands of companies
across the country and on the Internet selling any type of product
you need to purchase.
Most are honest, but beware (of course - everything can involve some
type of fraud) of those who are not.
DME companies have been caught billing insurance carriers (and
Medicare/Medicaid) for
- Products not delivered
- Billed for higher costing products that those delivered.
- Billed for new equipment, when the actual equipment was
used.
- Billed for a DME product when the customer actually
walked away with a new coffee pot and toaster.
There can also be kickback schemes involving health care providers
and DME companies (or the sales reps), where the provider is paid to
prescribe a DME device, even though one is not needed.
Another crucial bit of information is the "Rental/Purchase
Agreement." 45 states require disclosures of various information.
One requirement of the disclosure (true in all 45 states) is that
information be disclosed on the agreement as to whether the
equipment is new or used. If you and/or your insurance company end
up purchasing the equipment for the "new" price, you have just been
scammed. Click here for statutes.
There are also plenty of products out there touting "FDA APPROVED."
Be advised...FDA approval does not mean the product really works,
only that it shouldn't harm you. Even today, there are snake oil
salesmen out there.
Also, be aware that several states require DME companies (either for
all or certain products) to be registered in their state before they
can sell their products. This includes but is not limited to:
Florida, Illinois, Ohio, North Carolina. Medicare and Medicaid
require registration. If your state requires registration and the
DME company is not registered, contact your State Attorney General
or Department of Health.
When purchasing durable medical device, always confirm the charges
submitted to your insurance carrier were correct.
Be wary of ads that tout they can get your insurance company to pay
for the equipment or you will get it free.
'Cause who pays the fraudsters?
YOU DO!
If you think a DME company is cheating, report them!