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Could you or your company be under investigation for DME fraud?

| Jan 29, 2021 | Uncategorized | 0 comments

As a provider of durable medical equipment, you may be aware that criminal investigations are ramping up against DME companies across the country.

If you sense that your company is a target, what should you do?

About DME fraud

Durable medical equipment companies provide patients with items such as walkers, wheelchairs, scooters, crutches, hospital beds and oxygen equipment. The federal government has stepped up its scrutiny of these companies, taking special note of their billing practices since some bill for equipment that is either unnecessary or never provided. Investigations have found that some DME companies forge prescriptions or medical records or submit false claims using stolen physician or patient identities.

Texas cases

DME fraud made headlines in two separate cases in the Lone Star State. After a five-year-long investigation, the federal government found that between 2009 and 2012, Texas-based The Scooter Store defrauded Medicare in the amount of $100 million. The government banned the company from filing claims for its motorized wheelchairs and fined it $4 million, causing The Scooter Store to file for bankruptcy in 2013. In yet another case involving bribes and illegal kickbacks, Texas DME suppliers were among 24 defendants in six states charged with healthcare fraud in April 2019.

Next steps

Federal investigations are usually complex and take time to unfold, so companies often become aware that they are potential targets. Whether you are already under investigation or only believe that an investigation is pending, the next step is ensuring that you have proper representation. If charged with fraud, you want the best outcome possible to protect your DME company and your career.