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DME Medicare fraud: fight against durable medical equipment fraud by false claim law

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Fraud in the supply of durable medical equipment (DME) is recognized as a problem spreading rapidly, widely spread by CMS and Ministry of Justice. According to the 2005 government report by the Government Accounting Office, the fraudulent payment amounted to more than $ 900 million out of the $ 8.8 billion US spending on endurance medical equipment in 2004. Medicare and Medicaid cover at least some of the cost of medically necessary equipment. In order to be eligible for Medicare refund, you must have a medical need certificate signed by your doctor. We must also meet Medicare clinical guidelines on the medical needs of specific equipment (such as home oxygen or insulin pumps). Many DME suppliers simply purchase equipment from DME manufacturers, ship them to patients, and act as "mediators" for claims insurance, including Medicare and Medicaid. Therefore, regulation is difficult, and patients are at risk of fraud. Common fraud practices that were developed by ...