Estimated read time: 3-4 minutes
SANDY — Medicare paid out thousands of dollars for a medical device on behalf of a Utahn that never ordered it, let alone received it. Turns out, she's caught up in a massive fraud scheme that could be costing taxpayers billions.
Gary Johnson discovered a discrepancy while examining his wife's Medicare statement.
"It was for some urinary catheters which my wife does not use, has never used," Johnson said. "A total of $15,500."
Medicare paid huge sums for the catheters that never showed up.
"It showed the name of a doctor of which I have no knowledge and it showed a place that was supplying the catheters in El Paso, Texas."
Johnson suspected fraud so he contacted the KSL Investigators.
"Lots of fraud going out there," he said. Indeed, there is, says Jackie Smith, program director of the Utah Senior Medicare Patrol — a program that aims to protect Medicare recipients from fraud.
"Medicare fraud is a big thing," she said. "They're estimating about $60 billion worth of fraud every year through Medicare."
Huge money and, for whatever reason, urinary catheters seem to be a major tool for these con artists. The inspector general for the U.S. Department of Health and Human Services recently issued a consumer alert regarding urinary catheter scams that warned folks to guard their Medicare numbers carefully.
"Treat your Medicare card like a credit card," Smith warned. "Don't give out that information, especially if you're getting a cold call from someone. Even if they already have your information and they're just verifying it — don't do that."
Smith says every Medicare recipient should review any explanation of benefits statement.
"Look at that every time. Make a note of when you go to see the doctor, what tests are done, what things you're getting, so that when you get your Medicare statement, you can match those two up and make sure everything looks right."
"I personally notified Medicare," Johnson told us.
While his wife isn't out anything personally because of this scheme, it is costing taxpayers billions of dollars he sure wishes would go to better use than lining the pockets of crooks.
"I hope that other people will carefully look at their explanation of benefits," he said.
"In the long run, the beneficiaries end up paying the bill with higher costs," said Smith. "The federal government ends up paying it and then … They've got to find the money somewhere."
If you do suspect fraudsters are billing your Medicare plan, the Feds say don't just ignore it. Report it here or call the Department of Health and Human Services' Office of Inspector General hotline at 1-800-HHS-TIPS.
And Smith says Utah's Senior Medicare Patrol has staff all over the state that can help you look at your Medicare explanation of benefits statement to see what is what.
"They can help you read those confusing notices, and let you know what to do if you feel like there is fraud."
