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A2 UP FRONT
Wednesday 10 april 2019
Feds charge 2 dozen in billion dollar Medicare brace scam

Associated Press ciated with the individuals
WASHINGTON (AP) — Fed- were disconnected. Others
eral agents on Tuesday did not respond to mes-
broke up a billion dollar sages.
Medicare scam that ped- The investigation is con-
dled unneeded orthope- tinuing. Authorities asked
dic braces to hundreds doctors who have been
of thousands of seniors. involved with telemedicine
Two dozen people were and medical equipment
charged, including doctors fraud to voluntarily come
accused of writing bogus forward.
prescriptions. Health care fraud is a per-
The Justice Department vasive problem that costs
said the scheme relied on taxpayers tens of billions of
overseas call centers to pry dollars a year. The true ex-
Medicare numbers from tent of it is unknown, and
beneficiaries. Authorities some cases involve gray
also announced charges areas of complex payment
against owners of call cen- policies.
ters, telemedicine firms Experts say part of the
and medical equipment problem is that Medicare
companies that shipped is required to pay medical
unneeded back, shoulder, bills promptly, which means
wrist and knee braces. money often goes out be-
Profits from the scheme In this photo provided by the Department of Health and Human Services, Office of Inspector Gen- fore potential frauds get
eral, HHS Office of Inspector General agents, take part in arrests Tuesday, April 9, 2019, in Queens,
were laundered through N.Y., as they break up a billion-dollar Medicare scam that peddled unneeded orthopedic braces flagged. Investigators call
offshore shell companies to hundreds of thousands of seniors nationwide, using a network of foreign call centers. that "pay and chase."
and then used to buy high- Associated Press In recent years, Medicare
end cars, yachts and luxury has tried to adapt tech-
homes here and abroad, paid out. involved. The FBI, the IRS braces. niques used by credit card
officials said. The loss to Medicare was and 17 U.S. attorney's of- The call centers would col- companies to head off
Medicare's anti-fraud estimated at more than fices took part in the crack- lect prescriptions and sell fraud. Law enforcement
unit said it's taking action $1.2 billion. down. them to medical equip- coordination has grown,
against 130 medical equip- The Health and Human Ser- "The telemedicine we are ment companies, which with strike forces of federal
ment companies implicat- vices inspector general's talking about is basically would ship the braces to prosecutors and agents,
ed. The companies billed office said the fast-moving a tele-scam," said Gary beneficiaries and bill Medi- along with state counter-
the program a total of $1.7 scam was fueled by kick- Cantrell, who oversees care. Medical equipment parts, specializing in health
billion, but not all of it was backs among the parties fraud investigations for the companies would get $500 care investigations.
HHS inspector general's of- to $900 per brace from Officials said the govern-
fice. "We are not talking Medicare and would pay ment has options to recoup
about the use of advanced kickbacks of nearly $300 at least some of the money
technology to provide bet- per brace. lost to Medicare, including
ter access to care." Officials said it's one of the seizing fraudsters' assets
Officials said the scam was biggest frauds the inspec- and accounts, as well as
detected last summer as tor general's office has property purchased with
complaints from beneficia- seen. Charges were being the proceeds of the scam.
ries poured in to the Medi- brought against defen- The Medicare beneficiaries
care fraud hotline. dants in California, Florida, drawn into the orthopedic
They said telemarketers New Jersey, Pennsylvania, braces scam didn't have
would reach out to seniors South Carolina and Texas. to pay anything up front,
offering "free" orthopedic Cantrell said federal agents but Cantrell said they have
braces, also touted through had gained cooperation been harmed as well: A
television and radio ads. from people familiar with beneficiary's private infor-
Interested beneficiaries the various schemes. mation, once in the hands
would be patched through "The breadth of this nation- of fraudsters, can be resold
to call centers, part of what wide conspiracy should be for many illegal purposes.
officials described as an frightening to all who rely Additionally, if a beneficia-
"international telemarket- on some form of health ry whose information was
ing network" with opera- care," IRS criminal investiga- misused ever does need
tions in the Philippines and tions chief Don Fort said in a an orthopedic brace, he or
throughout Latin America. statement. "The conspiracy she may encounter waiting
After verifying Medicare ... details broad corruption, periods from Medicare. The
coverage, the seniors massive amounts of greed program limits how often
would be transferred to and systemic flaws in our it pays for certain supplies
telemedicine companies health care system that and equipment.
for consultations with doc- were exploited by the de- "It can be very attractive
tors, who wrote prescrip- fendants." to receive equipment,"
tions for orthopedic braces, Attempts to reach defen- Cantrell said. "But after giv-
regardless of whether the dants named by the Jus- ing out your identifying in-
patients needed them or tice Department were un- formation, it could be com-
not. Sometimes the same successful. In several cases promised to perpetuate
patient would get several telephone numbers asso- additional fraud. q