Medicae Fraud

[Nueces]

Some months back, there was discussion on my NextDoor page about a common Medicare fraudulent claim. I took a look and found one like it on my record, so I called Medicare to report it. Complete waste of time. Could not get the phone rep to comprehend that I was reporting fraud and I don’t think there was any follow up.

Last week, I got a regular email notice of recent Tricare claims and checked (as I now do with Medicare). Tricare had denied a claim that I could tell was fraudulent, but I had not yet heard from Medicare. So, I logged into Medicare and found a large fake claim that Medicare had already paid.

The claim had been filed in December, but it covered 10 monthly charges of $1900, dating from Feb 2023 to Nov 2023. Total claim was $19,000 and Medicare had paid $15K of that, then sent it to Tricare, who, properly, balked.

Each monthly claim was for “200 Intermittent urinary catheter, with insertion supplies (A4353-KX).” Geez, that’s not fun even to read. Physician was some starkly unpronounceable southern Asian name in Fort Lauderdale.

This time, I found a “whistle blower” link on the Medicare site and made an online report. Yesterday I received a new Medicare card and number, so the report worked.

Y’all watch out, y’hear?

[schutzen-jager]

call your federal congressional representatives + ask them to follow up + report back to you on your initial report - if no answer send registered letter to congressional office in D.C. -

[Rockindaddy]

I get calls every day from India. They come up all kinds of reasons to bill Medicare. When you call back the phone number they are using it is a number not in use. I block them but our representatives in DC need to suspend all aid to India until their government jails these scammers.

[elmacgyver0]

I get calls every day from India. They come up all kinds of reasons to bill Medicare. When you call back the phone number they are using it is a number not in use. I block them but our representatives in DC need to suspend all aid to India until their government jails these scammers.

Yeh...that'l happen

[gifbohane]

How about just suspend all aid to India.

[ascast]

How about just suspend all aid to India.

I like this ^^^

[MUSTANG]

I'll see your suspend all Aid to India and Raise you, "SUSPEND ALL AID EVERYWHERE".

[William Yanda]

Yeh...that'l happen

Did you mean: Yeh...that'l happen!

[DougGuy]

So.. Bidenomics dictate that India is just about or already has joined BRICS, quick we should send them MORE AID!

[blackthorn]

Nueces (medical fraud thread) said: “The claim had been filed in December, but it covered 10 monthly charges of $1900, dating from Feb 2023 to Nov 2023. Total claim was $19,000 and Medicare had paid $15K of that, then sent it to Tricare, who, properly, balked.

Each monthly claim was for “200 Intermittent urinary catheter, with insertion supplies (A4353-KX).” Geez, that’s not fun even to read. “

I almost could not believe the cost quoted for 200 catheters. Due to some problems (old age) I was recently put on self catheterization that must be done 3 times a day. One hundred single use lubricated catheters plus 2 good sized tubes of lubricant for use with the reusable ones (that are less convenient when I travel) came to $164 dollars plus change. Other than the inconvenience, using the catheter in the middle of the day, it has not been too bad. I was offered a surgical option that was estimated to be a 50/50 chance of successfully fixing the problem and would require a 3 or 4 day stay in hospital, considerable pain and several weeks of recovery time. After using the catheter for a couple of weeks, considering the risk of picking up something else in hospital and talking to my Dr. I decided, at my age (85) using the device was not fun but was likely my best option.

[higgins]

Last year I had two fradulent claims for Covid home test supplies and one fraudulent claim for catheters. I reported all of them and have not had any fradulent claims for the last few months. Note that it's for items for which Medicare pays 100 percent so any suppliemental insurance carriers don't get involved, which probably would have caught some of them. I googled one of the covid test kit suppliers and found that Medicare had already sued them to recover many millions, but they were still paying claims to the same company! There is apparently little to no oversight of Medicare spending, but they won't hesitate to increase premiums and deductibles to cover increased costs.

[Pereira]

I'll see your suspend all Aid to India and Raise you, "SUSPEND ALL AID EVERYWHERE".

Ding, Ding, Ding, and we have a Winner.

RP