Durable Medical Equipment Fraud
Tips for Protecting Yourself and Medicare
In 2009, Medicare spent more than $10 billion on durable medical equipment. More than half of that was improperly spent. That means the equipment was unnecessary or the bill was wrong.
What is Durable Medical Equipment?
Durable medical equipment, or DME, is medical equipment prescribed by your doctor that is reusable. It includes hospital beds, walkers, wheelchairs, home oxygen equipment, scooters and prosthetics. Medicare only covers DME if you get it from a supplier enrolled in the Medicare program.
What Are Examples of DME Fraud?
- Suppliers who offer “free” equipment but bill Medicare
- Suppliers who want you to use their doctors (who then prescribe unnecessary medical equipment)
- Doctors or suppliers who provide medical equipment you never needed or requested, or charge for items you never received
- Companies that bill for duplicate orders
- Older adults who willingly accept unnecessary equipment or supplies, or allow their Medicare number to be used in exchange for money or other things
How to Protect Yourself and Medicare from DME Fraud
- Always read your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) to look for any charges for equipment you do not need or did not receive.
- Protect your Medicare, Medicaid and Social Security cards like a credit card.
- Know that Medicare medical suppliers are not allowed to make unsolicited telephone calls or send e-mails to sell you equipment unless you’ve done business with them in the last 15 months.
- Never sign a blank form from your health care provider or equipment supplier.
- Refuse and report anyone offering “free” equipment, supplies or services in exchange for your Medicare number.
- If you rent and return medical equipment, always get a dated receipt.
How Your Senior Medicare Patrol (SMP) Can Help
Your local SMP is ready to provide you with the information you need to PROTECT yourself from Medicare errors, fraud and abuse; DETECT potential errors, fraud and abuse; and REPORT your concerns. SMPs use trained senior volunteers to help educate and empower seniors in the fight against health care fraud. Your SMP can help you with questions, concerns or complaints about potential fraud and abuse issues. It also provides information and educational presentations.