Physicians can become entangled in DME fraud

Federal investigators are cracking down on Medicare supply schemes.

By David Glendinning, AMNews staff. March 17, 2008.

Washington -- Despite federal efforts to curtail it, fraud involving durable medical equipment, prosthetics, orthotics and supplies is still a big problem for Medicare, says the Centers for Medicare & Medicaid Services. The agency recently announced it will expand a competitive bidding program for equipment suppliers. It also will require that suppliers be accredited before they can bill Medicare.

Meanwhile, investigators continue to crack down on suppliers and physicians who commit Medicare fraud. AMNews spoke with Staci Spector, an investigative assistant in CMS' Los Angeles field office, about what doctors need to know about DME fraud.

AMNews: What are some of the DME fraud schemes that involve physicians?

Spector: The common scheme we're seeing is that these fraudulent DME clinics or suppliers are recruiting physicians to act as referring physicians. We've done about 40 interviews with referring physicians that have led to administrative actions against hundreds of DME suppliers. What we're finding is these physicians are being recruited and not really knowing why.

Usually these DME suppliers will put an ad in the newspaper that says [they] need someone as an attending physician. [Doctors] are told to come into the clinic and sign off on medical charts. Usually once they get to the clinic, there are no patients and the medical charts are fake. So they're just signing off on fake charts.