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DME Telemedicine Scams

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  • Avatar MrsIMDoc 
    Participant
    Status: Physician
    Posts: 200
    Joined: 01/09/2016

    I would consult a lawyer to try and rectify the 5 charts you have done. I know someone who got charged with medicare fraud for this even with just a few charts.  Now she can’t practice as an internist for two years (can’t bill medicare), effectively ending her career.

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    Can you elaborate a bit on the nature of the fraud committed?  I do plan on consulting an attorney.  Even 5 charts scares me.

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    She was doing chart review and ordering braces as a side gig.  Thought it was telemedicine and ok but ultimately it was not. She now cannot bill medicare for 2 years.

    #160512 Reply
    fatlittlepig fatlittlepig 
    Participant
    Status: Physician
    Posts: 748
    Joined: 01/26/2017

    I would consult a lawyer to try and rectify the 5 charts you have done. I know someone who got charged with medicare fraud for this even with just a few charts.  Now she can’t practice as an internist for two years (can’t bill medicare), effectively ending her career.

    Click to expand…

    Can you elaborate a bit on the nature of the fraud committed?  I do plan on consulting an attorney.  Even 5 charts scares me.

    Click to expand…

    She was doing chart review and ordering braces as a side gig.  Thought it was telemedicine and ok but ultimately it was not. She now cannot bill medicare for 2 years.

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    Lol I bet the op is not happy to read this post. Heh heh

    #160514 Reply
    Avatar MrsIMDoc 
    Participant
    Status: Physician
    Posts: 200
    Joined: 01/09/2016

    I would consult a lawyer to try and rectify the 5 charts you have done. I know someone who got charged with medicare fraud for this even with just a few charts.  Now she can’t practice as an internist for two years (can’t bill medicare), effectively ending her career.

    Click to expand…

    Can you elaborate a bit on the nature of the fraud committed?  I do plan on consulting an attorney.  Even 5 charts scares me.

    Click to expand…

    She was doing chart review and ordering braces as a side gig.  Thought it was telemedicine and ok but ultimately it was not. She now cannot bill medicare for 2 years.

    Click to expand…

    Lol I bet the op is not happy to read this post. Heh heh

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    Definitely not trying to be hard on the OP. The scary part of all this is that there are scammers that look for physicians to do this.  They get shut down but set under a different name and get new physicians.

    #160521 Reply
    Liked by RocDoc
    Avatar SLC OB 
    Participant
    Status: Physician
    Posts: 456
    Joined: 06/23/2018
    medical school scholarship sponsor
    Lol I bet the op is not happy to read this post. Heh heh

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    Why would you say this? I usually get a kick out of your posts but this is just plain mean.

    Time to roast the fatlittlepig?

    #160556 Reply
    fatlittlepig fatlittlepig 
    Participant
    Status: Physician
    Posts: 748
    Joined: 01/26/2017
    Lol I bet the op is not happy to read this post. Heh heh 

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    Why would you say this? I usually get a kick out of your posts but this is just plain mean.

    Time to roast the fatlittlepig?

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    LOL, read some of his older posts. Doing all of these weird marginal telemedicine things, completely unnecessary.

    #160571 Reply
    Avatar ebotrd 
    Participant
    Status: Physician
    Posts: 14
    Joined: 10/25/2018

    UPDATE:

    Had some patients assigned to me.  The paperwork you’re signing off states:

    “I, [Dr. DME], verify and confirm this order for the above named patient, and certify that I have personally performed the assessment of the patient for the prescribed treatment and device and verify that it is reasonably and medically necessary, according to accepted standards of medical practice within the community, for this patient’s medical conditions.”

    “STATEMENT OF MEDICAL NECESSITY
    I certify that the patient has the medical condition(s) listed and is being treated by me. All the information contained on this physician’s order accurately reflects the patient’s medical condition(s) and is medically necessary with reference to the standards of medical practice for this patient’s condition(s). The medical records for this patient substantiate the prescribed treatment plan.”

    I thought it was suspicious that all the notes seem to state that they report 9/10 pain, no matter which body part or which patient.  Also, over half the patients have more than one brace order.  RediDoc stated they’d pay me $20 per brace prescribed, and $30 per topical analgesic.

    The statement above does state that I performed the assessment so it seemed prudent to call a few of these patients and see if these they  really think these braces will help them.  I called 3.  I was very disappointed in what they told me about their RediDoc interactions.

    ___________________________________

    My email to their “Director of the Physician Support Department” sums it up:

    Dear, ____,
    I read through the histories and called some of the patients RediDoc sent me over the past few days. Thus far and 3 out of 3 patients recounted for me that their histories taken were not accurate, and that they did not want the back, shoulder, wrist, or knee braces that RediDoc stated they requested.
    If any of the patients truly felt the DME goods might benefit them, I would be be happy to help in this small way.  However, since it appears 3 of 3 were approached by RediDoc unsolicited and reported that the histories taken were inaccurate, this does not appear to be the case.  Having read about Medicare DME fraud, I would be concerned about being associated with this company.  I feel Medicare will have a tough enough time in the coming years as it is.
    I’m open to hearing any response you have to this concerning finding.
    Thank you.
    ___________________________________
    Our colleagues participating in this I’m sure are doing well for themselves.  I would think they’d quickly stop bothering to call the patients at all, since none of them want these braces.  If they did call anyway, I’m sure it’s a very brief call so they can get off the phone before the patient angrily objects to being sent the DME they don’t want.  If I signed off on all the 30 some brace prescriptions already sent to me with a brief/no phone call, I’d make around $600 in probably 20 minutes.
    What a racket.
    When Medicare fraud investigators dig into this, I would think the physicians involved would be targeted as well because they’re obviously prescribing DME the patients aren’t requesting or even want for free.  Plus, they’re probably not even calling the patients, but yet sign off that they “certify that I have personally performed the assessment of the patient for the prescribed treatment and device and verify that it is reasonably and medically necessary”.
    I’ll continue to look for legit telemedicine opportunities or just resign to doing shifts at a local urgent care.  At least I’ll feel good about what I’m doing.
    #160785 Reply
    fatlittlepig fatlittlepig 
    Participant
    Status: Physician
    Posts: 748
    Joined: 01/26/2017

    UPDATE:

    Had some patients assigned to me.  The paperwork you’re signing off states:

    “I, [Dr. DME], verify and confirm this order for the above named patient, and certify that I have personally performed the assessment of the patient for the prescribed treatment and device and verify that it is reasonably and medically necessary, according to accepted standards of medical practice within the community, for this patient’s medical conditions.”

    “STATEMENT OF MEDICAL NECESSITY
    I certify that the patient has the medical condition(s) listed and is being treated by me. All the information contained on this physician’s order accurately reflects the patient’s medical condition(s) and is medically necessary with reference to the standards of medical practice for this patient’s condition(s). The medical records for this patient substantiate the prescribed treatment plan.”

    I thought it was suspicious that all the notes seem to state that they report 9/10 pain, no matter which body part or which patient.  Also, over half the patients have more than one brace order.  RediDoc stated they’d pay me $20 per brace prescribed, and $30 per topical analgesic.

    The statement above does state that I performed the assessment so it seemed prudent to call a few of these patients and see if these they  really think these braces will help them.  I called 3.  I was very disappointed in what they told me about their RediDoc interactions.

    ___________________________________

    My email to their “Director of the Physician Support Department” sums it up:

    Dear, ____,
    I read through the histories and called some of the patients RediDoc sent me over the past few days. Thus far and 3 out of 3 patients recounted for me that their histories taken were not accurate, and that they did not want the back, shoulder, wrist, or knee braces that RediDoc stated they requested.
    If any of the patients truly felt the DME goods might benefit them, I would be be happy to help in this small way.  However, since it appears 3 of 3 were approached by RediDoc unsolicited and reported that the histories taken were inaccurate, this does not appear to be the case.  Having read about Medicare DME fraud, I would be concerned about being associated with this company.  I feel Medicare will have a tough enough time in the coming years as it is.
    I’m open to hearing any response you have to this concerning finding.
    Thank you.
    ___________________________________
    Our colleagues participating in this I’m sure are doing well for themselves.  I would think they’d quickly stop bothering to call the patients at all, since none of them want these braces.  If they did call anyway, I’m sure it’s a very brief call so they can get off the phone before the patient angrily objects to being sent the DME they don’t want.  If I signed off on all the 30 some brace prescriptions already sent to me with a brief/no phone call, I’d make around $600 in probably 20 minutes.
    What a racket.
    When Medicare fraud investigators dig into this, I would think the physicians involved would be targeted as well because they’re obviously prescribing DME the patients aren’t requesting or even want for free.  Plus, they’re probably not even calling the patients, but yet sign off that they “certify that I have personally performed the assessment of the patient for the prescribed treatment and device and verify that it is reasonably and medically necessary”.
    I’ll continue to look for legit telemedicine opportunities or just resign to doing shifts at a local urgent care.  At least I’ll feel good about what I’m doing.
    Click to expand…

    After writing that huge post, you then wrote that you will continue to look for other telemedicine opportunities. Sorry but you sound very foolish.

    #160792 Reply
    CordMcNally CordMcNally 
    Participant
    Status: Physician
    Posts: 2255
    Joined: 01/03/2017

    To be fair, about 95% of the patients I see in the ED with some form of pain complaint describe it as at least 9/10, usually while texting and eating Cheetos. I wouldn’t even waste your time writing the company. I would try to distance yourself. Maybe even inform Medicare. Maybe you’ll get some whistle blower money. If so, maybe telemedicine was worth your time.  😉

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #160797 Reply
    Avatar East coast 
    Participant
    Status: Other Professional
    Posts: 112
    Joined: 03/06/2016

    Just saw a commercial in Chicago for a local CBS investigative report on people receiving unwanted braces via medicare – maybe it’s the same company. Couldn’t find the actual news clip, but should be on the local evening news.

    #160819 Reply
    Avatar ebotrd 
    Participant
    Status: Physician
    Posts: 14
    Joined: 10/25/2018

    Please let me know if anyone knows a Medicare fraud reporting mechanism.  Thanks everyone.

    #160872 Reply
    Liked by LAMiller
    CordMcNally CordMcNally 
    Participant
    Status: Physician
    Posts: 2255
    Joined: 01/03/2017

    Please let me know if anyone knows a Medicare fraud reporting mechanism.  Thanks everyone.

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    How To Report Medicare Fraud. These are typically for the patient but I’m sure they can help if you call the number.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #160881 Reply
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 5755
    Joined: 01/12/2016

    Please let me know if anyone knows a Medicare fraud reporting mechanism.  Thanks everyone.

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    How To Report Medicare Fraud. These are typically for the patient but I’m sure they can help if you call the number.

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    Those always go after providers, not services that use providers. Has to be a wider way to look at these things, am always shocked how they say they cant stop that kind of thing.

    #160886 Reply
    Avatar East coast 
    Participant
    Status: Other Professional
    Posts: 112
    Joined: 03/06/2016
    Splash Refinancing Bonus

    Here’s the news reel – sounds exactly as described, although apparently the doctors involved in this one got $30/brace. You shoulda negotiated for a better rate apparently.

     

    Medical Supply Phone Scam Targets Seniors, Costs Medicare Millions

    #161024 Reply
    Drop it into MD Drop it into MD 
    Participant
    Status: Physician
    Posts: 440
    Joined: 09/20/2018

    We get just to the office all the time, “sign here so the patient can get such and such DME”  Rarely does the patient actually request anything from these companies or even know about it.  There are a ton of scams out there.  I used to call and complain but there did not get me anywhere so now it all just goes into the shred bin.

    #161030 Reply
    Avatar MrsIMDoc 
    Participant
    Status: Physician
    Posts: 200
    Joined: 01/09/2016

    We get just to the office all the time, “sign here so the patient can get such and such DME”  Rarely does the patient actually request anything from these companies or even know about it.  There are a ton of scams out there.  I used to call and complain but there did not get me anywhere so now it all just goes into the shred bin.

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    Is this your personal patient? I actually may sign something like that on accident if I see it is my patient and a DME request.  I do rehab care so I get alot of DME forms for my patient, I do NOT always pull up their chart to confirm they had knee pain, etc, to sign for the DME.

    #161042 Reply

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