WAHPETON — Medicare fraud continues to cost taxpayers billions of dollars each year, and North Dakota officials say seniors across the state are increasingly becoming targets of sophisticated scams involving medical equipment and stolen Medicare information.
According to Brenda Munson, project director of the North Dakota Senior Medicare Patrol, Medicare fraud costs approximately $60 billion annually nationwide.
“Roughly 10 cents of every dollar that’s appropriated for Medicare is actually stolen or misdirected before it ever even reaches the Medicare beneficiary,” Munson said.
One of the fastest-growing fraud schemes affecting North Dakota residents involves durable medical equipment, particularly urinary catheter devices.
Munson said some Medicare beneficiaries have discovered they were billed for hundreds of catheter devices they never ordered, needed or received.
“We are actually working with individuals right now that have been billed for 300 urinary catheter devices a month,” Munson said. “They’re billing Medicare about $13,000 to $14,000 for five to six months of these urinary catheter devices.”
Other common scams involve back braces, neck braces, ankle braces and other orthopedic devices. In many cases, fraudsters obtain a beneficiary’s Medicare number and use it to submit false claims.
“The scammers are exploiting medical supply systems by buying up these small established companies,” Munson said. “Then what they do is they use them to funnel fraudulent profits through products like back braces or these urinary catheter devices.”
Beyond financial losses, Medicare fraud can have serious consequences for a person’s medical care.
If a fraudulent claim is submitted for an expensive mobility device such as a scooter, a beneficiary may later face difficulties obtaining equipment that they legitimately need.
“It can be detrimental to their healthcare,” Munson said.
The emotional impact can also be significant.
“First of all, they’re ashamed,” Munson said. “The individuals that this happens to are ashamed. They don’t really even want to talk about it.”
Many victims lose sleep and are uncertain where to turn for help after discovering fraudulent activity, she said.
Officials encourage Medicare beneficiaries to carefully review their Medicare Summary Notices, which detail healthcare services and equipment billed to Medicare.
Munson said most fraud cases are discovered when beneficiaries or family members notice charges for services or equipment they never received.
“That Medicare summary notice is where I would say 95% of the fraud is discovered,” she said.
To help detect fraud, officials recommend keeping records of doctor visits, tests and medical procedures so beneficiaries can compare them against Medicare statements when they arrive.
People who are comfortable using technology can also create an account at Medicare.gov to monitor claims more quickly.
Munson advises residents never to provide Medicare numbers, Social Security numbers or banking information to unsolicited callers.
“If somebody is calling and saying that you are getting a new Medicare card, stop right there and hang up because that is a scam call,” she said.
She noted that Medicare will never call beneficiaries asking them to verify their Medicare number.
If fraud is suspected, beneficiaries can contact the Centers for Medicare & Medicaid Services or the North Dakota Senior Medicare Patrol at 833-818-0029.
The Senior Medicare Patrol is observing Medicare Fraud Prevention Week from June 1-5 through outreach efforts, educational campaigns and public awareness initiatives.
Munson said preventing Medicare fraud requires cooperation among beneficiaries, family members, caregivers, healthcare providers and government agencies.
“Everybody plays a part in the fight against Medicare fraud,” she said.
Shoba Dasari is the assistant managing editor for the Wahpeton Daily News and Richland County News-Monitor. Shoba can be reached by calling (701) 291-3548 or emailing shoba.dasari@wahpetondailynews.com.
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