[JRcorvette]

Be sure to check your Medicare Statement. I received mine the other day and there was a $5600 charge for various medical equipment on there. I called the listed doctor here in the villages but they would not help me at all. So I called Medicare and reported the claim (which has been Paid). The equipment charge came from Dune Medical Supply out of NC. Medicare stated that they have had other complaints about this company. They are sending the claim to the Fraud department. The scary thing is that they had my Medicare # and Name and SS # to place the claim. Now I have to contact my Medigap carrier and report it.

PS: The Medicare office was quick and efficient…. I was not on holds for a very long time. What a pleasant surprise!

[retiredguy123]

In my opinion, the Medicare Fraud Department is a joke. It's purpose is a publicity measure to make people think that the Government is trying to eliminate fraud. The problem is that, there is so much fraud with Medicare, with totally inadequate resources to prosecute it, that reporting fraud to the Fraud Department is a waste of time. There are so many fraudulent Medicare claims that there is no need to have a Fraud Department. The money would be better spent hiring prosecutors who will actually prosecute and punish fraud.

Also, if Medicare said they had other complaints about the company, why did they send them $5,600 of taxpayer money?

[JRcorvette]

Originally Posted by retiredguy123

In my opinion, the Medicare Fraud Department is a joke. It's purpose is a publicity measure to make people think that the Government is trying to eliminate fraud. The problem is that, there is so much fraud with Medicare, with totally inadequate resources to prosecute it, that reporting fraud to the Fraud Department is a waste of time. There are so many fraudulent Medicare claims that there is no need to have a Fraud Department. The money would be better spent hiring prosecutors who will actually prosecute and punish fraud.

Also, if Medicare said they had other complaints about the company, why did they send them $5,600 of taxpayer money?

Yes if they don’t prosecute and get convictions then what’s the point. I called the Doctors office and I believe that he is in on the scam because he recommended the equipment using My Medicare information! That ****es me off !

[kkingston57]

Originally Posted by JRcorvette

Be sure to check your Medicare Statement. I received mine the other day and there was a $5600 charge for various medical equipment on there. I called the listed doctor here in the villages but they would not help me at all. So I called Medicare and reported the claim (which has been Paid). The equipment charge came from Dune Medical Supply out of NC. Medicare stated that they have had other complaints about this company. They are sending the claim to the Fraud department. The scary thing is that they had my Medicare # and Name and SS # to place the claim. Now I have to contact my Medigap carrier and report it.

PS: The Medicare office was quick and efficient…. I was not on holds for a very long time. What a pleasant surprise!

Good eye. Surprised that company was not out of Miami. That city was a hot bed of similar scams years ago

[Topspinmo]

Originally Posted by retiredguy123

In my opinion, the Medicare Fraud Department is a joke. It's purpose is a publicity measure to make people think that the Government is trying to eliminate fraud. The problem is that, there is so much fraud with Medicare, with totally inadequate resources to prosecute it, that reporting fraud to the Fraud Department is a waste of time. There are so many fraudulent Medicare claims that there is no need to have a Fraud Department. The money would be better spent hiring prosecutors who will actually prosecute and punish fraud.

Also, if Medicare said they had other complaints about the company, why did they send them $5,600 of taxpayer money?

IMO Medicare supplements are fraud. That should already be covered on Medicare. But, IMO all insurance con.

[Killarneytime]

I am new to The Villages and peruse through these when I have time. I cannot not sleep tonight and read this. Some quick info doing quick research:

• - Dune Medical Supply is out of HighPoint
• - Website is sketchy - the ones that have no contact info beyond gmail is a red flag (and gmail for a business like this also raises flags)
• - Further digging I found that the owner of Dune Medical was indicted for Medicare Fraud and Arrested in August in NC Middle District Court
• - I also noticed in google trends that this small website was one of the most popular being sought out in February and March before indictment, with most of that search activity coming from the D.C area

That said, I am not a medicare person (still working and below 65) but as you said, someone has to sign off on this. It will be interesting to see what comes out of this.

EDIT/ADD - After further review, the guy arrested was noted in corporate filings as a “Manager”. The register owner/agent is a different name who is sketch as he has registered many LLcs in the past few years from investing to marketing, and medical supplies. Most closed. Same address for all. In any case I dint want to imply docs are involved. This group would simply bill people for supplies without docs knowledge.

[golfing eagles]

Originally Posted by JRcorvette

Yes if they don’t prosecute and get convictions then what’s the point. I called the Doctors office and I believe that he is in on the scam because he recommended the equipment using My Medicare information! That ****es me off !

Did the doctor's office state that yes, he did order the equipment????? Or was that an assumption based on the Medicare EOB? On numerous occasions my patients were scammed and actually received equipment that they stated I ordered when I did nothing of the sort. I would find it highly unusual that your doctor would order "various medical equipment" without telling you or explaining what its purpose was. So, I must ask, are you sure you really want to state your doctor is "in on the scam" on a public forum???

[golfing eagles]

Originally Posted by Topspinmo

IMO Medicare supplements are fraud. That should already be covered on Medicare. But, IMO all insurance con.

Sure, no problem. You are, of course, willing to pay the massive tax increase for the rest of us????

[golfing eagles]

Originally Posted by retiredguy123

In my opinion, the Medicare Fraud Department is a joke. It's purpose is a publicity measure to make people think that the Government is trying to eliminate fraud. The problem is that, there is so much fraud with Medicare, with totally inadequate resources to prosecute it, that reporting fraud to the Fraud Department is a waste of time. There are so many fraudulent Medicare claims that there is no need to have a Fraud Department. The money would be better spent hiring prosecutors who will actually prosecute and punish fraud.

Also, if Medicare said they had other complaints about the company, why did they send them $5,600 of taxpayer money?

Trust me, if you worked as a provider of medical services, you would never consider their fraud department "a joke". I wonder on what basis people make posts like this.

I will state this, however----they spend way too much money to uncover the amount of fraud that they recover. I could find 10x as much fraud with 5% of their budget---it's very easy with the data they have. Just print out a list of non-institutional providers that bill Medicare/Medicaid the most and work the list top down. I assure you a solo private medical practice that bills Medicare 50 million/year or a small private lab that bills $100 million is committing fraud. At times it seems they work harder to recover $11.95 in overcharges.

[retiredguy123]

Originally Posted by golfing eagles

Did the doctor's office state that yes, he did order the equipment????? Or was that an assumption based on the Medicare EOB? On numerous occasions my patients were scammed and actually received equipment that they stated I ordered when I did nothing of the sort. I would find it highly unusual that your doctor would order "various medical equipment" without telling you or explaining what its purpose was. So, I must ask, are you sure you really want to state your doctor is "in on the scam" on a public forum???

Possibly, but the worst scammer in this case is Medicare and their employee who told the OP that they already knew the equipment supply company was fraudulent, and yet, they still paid the company $5,600.

[retiredguy123]

Originally Posted by golfing eagles

Trust me, if you worked as a provider of medical services, you would never consider their fraud department "a joke". I wonder on what basis people make posts like this.

I will state this, however----they spend way too much money to uncover the amount of fraud that they recover. I could find 10x as much fraud with 5% of their budget---it's very easy with the data they have. Just print out a list of non-institutional providers that bill Medicare/Medicaid the most and work the list top down. I assure you a solo private medical practice that bills Medicare 50 million/year or a small private lab that bills $100 million is committing fraud. At times it seems they work harder to recover $11.95 in overcharges.

The basis for my post is being employed as an Inspector General for the Federal Government for more than 20 years. There is so much fraud within the Federal Government, including Medicare, that you don't need to set up a fraud department to find it. Just read some IG reports. Fraud is extremely easy to find, but the hard part is getting people, who control the spending, to eliminate it. In my opinion, the primary purpose of their Fraud Department is for publicity to fool people into thinking they are fighting fraud. I even remember several years ago when Medicare paid for a television ad campaign to promote their supposed efforts to expose fraud.

[golfing eagles]

Originally Posted by retiredguy123

The basis for my post is being employed as an Inspector General for the Federal Government for more than 20 years. There is so much fraud within the Federal Government, including Medicare, that you don't need to set up a fraud department to find it. Just read some IG reports. Fraud is extremely easy to find, but the hard part is getting people, who control the spending, to eliminate it. In my opinion, the primary purpose of their Fraud Department is for publicity to fool people into thinking they are fighting fraud. I even remember several years ago when Medicare paid for a television ad campaign to promote their supposed efforts to expose fraud.

I can certainly agree with that. Not only fraud, but just wasteful, useless spending as well. It's long past time that our country's leaders stop handing out "goodies" in return for favors/votes/remaining in power. Maybe we'll get lucky and the person who stated they will find $1 trillion in waste delivers.

[CoachKandSportsguy]

Originally Posted by JRcorvette

Be sure to check your Medicare Statement. I received mine the other day and there was a $5600 charge for various medical equipment on there. I called the listed doctor here in the villages but they would not help me at all. So I called Medicare and reported the claim (which has been Paid). The equipment charge came from Dune Medical Supply out of NC. Medicare stated that they have had other complaints about this company. They are sending the claim to the Fraud department. The scary thing is that they had my Medicare # and Name and SS # to place the claim. Now I have to contact my Medigap carrier and report it.

PS: The Medicare office was quick and efficient…. I was not on holds for a very long time. What a pleasant surprise!

My mom got a new Medicare nbr after her information was leaked in a big ID theft by the network data transfer agent.

See if you can get a newMedicare number, since your number was probably part of one of the health ID thefts. Dune Medical probably bought the information on the black web, and they just open and close the LLCs so that the govt is always behind in getting to them while they are active, since the government is so slow.

Good luck to us!

[JMintzer]

Originally Posted by golfing eagles

Trust me, if you worked as a provider of medical services, you would never consider their fraud department "a joke". I wonder on what basis people make posts like this.

I will state this, however----they spend way too much money to uncover the amount of fraud that they recover. I could find 10x as much fraud with 5% of their budget---it's very easy with the data they have. Just print out a list of non-institutional providers that bill Medicare/Medicaid the most and work the list top down. I assure you a solo private medical practice that bills Medicare 50 million/year or a small private lab that bills $100 million is committing fraud. At times it seems they work harder to recover $11.95 in overcharges.

So true...

I was investigated by Medicare 3 Xs over my career.

The first time, they wound up owing ME about $145.00. That was due to the juxtaposition of pt ID #s, resulting in me not getting paid for something I was legally due to receive...

The 2nd time, I owed them about $99.00. Again, due to a clerical error.

The third time, my charts documented that I charged the correct amount and no action was taken.

So, god knows how much money was spent by their auditors. My staff had to spend hours writing letters and sending records. And the audit didn't help my stress level...

I won't even start on the the time they send me a VERY threatening letter accusing me of treating a dead person.

Now, I'm pretty sure I didn't sleep the class on how to make sure your patient is alive, but I digress...

Turns out, I did a hospital consult on a ver sick patient at lunchtime to develop a tx plan for their decubitus (heel) ulcers. I examined the patient, dressed the wounds and wrote a note, delineating my suggested plan.

Sadly, later that evening, the pt coded and died (about 8 hours after I had seen the pt). I never knew this happened as the floor never called me again about the pt (as I had requested in my note).

Again, the stress of opening that threatening letter from Medicare and then having to dig thru the hospitals medical records was a joy... /sarcasm...

[golfing eagles]

Originally Posted by JMintzer

So true...

I was investigated by Medicare 3 Xs over my career.

The first time, they wound up owing ME about $145.00. That was due to the juxtaposition of pt ID #s, resulting in me not getting paid for something I was legally due to receive...

The 2nd time, I owed them about $99.00. Again, due to a clerical error.

The third time, my charts documented that I charged the correct amount and no action was taken.

So, god knows how much money was spent by their auditors. My staff had to spend hours writing letters and sending records. And the audit didn't help my stress level...

I won't even start on the the time they send me a VERY threatening letter accusing me of treating a dead person.

Now, I'm pretty sure I didn't sleep the class on how to make sure your patient is alive, but I digress...

Turns out, I did a hospital consult on a ver sick patient at lunchtime to develop a tx plan for their decubitus (heel) ulcers. I examined the patient, dressed the wounds and wrote a note, delineating my suggested plan.

Sadly, later that evening, the pt coded and died (about 8 hours after I had seen the pt). I never knew this happened as the floor never called me again about the pt (as I had requested in my note).

Again, the stress of opening that threatening letter from Medicare and then having to dig thru the hospitals medical records was a joy... /sarcasm...

Yep, about part for the course. I never had that joy, other than the usual 25 note chart audits. The one discrepancy they found resulted in them paying me an additional $45.00 because I under coded one visit. This is exactly my point----billions of dollars in real fraud and they spend a fortune investigating chump change amounts. I never understood why they didn't just start with the number 1 Medicare (non-institutional) biller and work their way down the list. Much cheaper and much more effective. (Of course that would require many less Federal employees and less spending, so......)