Medicare Catheter Fraud Could Cost the Public $2 Billion

On January 9, 2024, The Washington Post and The New York Times reported on a suspected $2 billion Medicare scam – alleging that seven medical equipment companies fraudulently billed Medicare for urinary catheters that were never ordered or received.

According to reports, one example of the fraud includes the companies billing nearly 406,000 patients for catheters in a two-year timeframe (up from 14 patients). The alleged Medicare scam could involve approximately $2 billion in illegal charges by the seven companies, which would account for nearly one-fifth of all Medicare spending on medical supplies in 2023.

Medicare fraud affects many people you know. In addition to using up people’s benefits faster, unauthorized fraudulent charges increase Medicare spending overall, which can result in increased premiums. Innocent people, primarily the elderly, may be victimized twice.

When taxpayer dollars are diverted from the lifesaving services and programs that Medicare provides, we all suffer. If you suspect Medicare or other healthcare fraud against the government, contact us or call us today at 1-888-292-8852.

Medicare billing scams may not be obvious

Individual catheters are cheap. That’s likely why the alleged Medicare catheter scam escaped the scrutiny applied to more expensive medical equipment and was able to continue so effectively.

A 2018 report by the Medicare Payment Advisory Commission found that Medicare paid substantially more than commercial payers for intermittent urinary catheters and recommended that Medicare consider incorporating catheters into its competitive bidding program.

Unfortunately, Medicare did not act on the recommendation at the time, and the seven accused companies may have taken advantage of this indifference by targeting catheters in their scheme.

This is hardly the first instance of alleged Medicare fraud. On June 28, 2023, the Department of Justice (DOJ) announced charges against 11 defendants for more than $2 billion in fraudulent claims resulting from telemedicine schemes. This scam also involved low-cost items billed to Medicare and other government insurers including orthotic braces, prescription skin creams, and other items that were medically unnecessary and ineligible for Medicare reimbursement.

Have you witnessed Medicare fraud against the government?

What you should do if you suspect Medicare fraud

The primary way the Department of Justice learns of Medicare and other healthcare fraud against the government is through whistleblowers working for or with the companies perpetuating the fraud. Without whistleblowers, most fraud against the government would go unpunished. If you suspect fraudulent business practices against the Medicare system, you can “blow the whistle” on the fraud under the False Claims Act.

And in a successful case, you may be entitled to a significant reward.

You must work with an attorney to file your qui tam claim. This filing notifies government attorneys so that they can investigate and decide whether to take over the lawsuit. Even if you’re not sure what you’re seeing is fraud, don’t delay in speaking confidentially with an experienced whistleblower attorney. Time is of the essence as the first whistleblower to file a case is in the best position to receive a possible life-changing award in a successful case.

Are you ready to blow the whistle on Medicare and healthcare fraud?

Coming forward is a brave and patriotic thing to do. If you suspect fraud against the government, we can help answer your questions and help you determine the next best steps for you.

Having an experienced whistleblower attorney on your side is critical. You want someone who has successfully resolved other whistleblower cases and knows the timeline, procedures, and requirements involved in fighting fraud via the False Claims Act.

Our team is led by former White-House appointed attorney Bill Nettles, who helped lead the nation on whistleblower recoveries during his tenure as U.S. Attorney for South Carolina.^1,4 Now in private practice, Bill knows how to partner with the government on behalf of whistleblowers. Bill and the team at Carolina Whistleblower Attorneys use their vast experience to help whistleblowers come forward with qui tam claims – and they do this by putting your needs first.

Always.

Businesses and healthcare professionals who exploit the Medicare system for illegal personal or corporate gain should be held accountable. You may be able to help protect the taxpaying public from this blatant greed and disregard for others’ welfare. And we can guide you throughout the entire process while taking steps to help protect you from retaliation.

Is someone using government funds fraudulently? For a free and completely confidential conversation about your situation, call us today at 1-888-292-8852.

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