Wednesday, July 25, 2012

Fraud

One of the things all docs dislike is the paperwork. It's a necessary evil; prescriptions, letters of medical necessity.
Of late though I think we're all seeing increasing cases of Medicare fraud. Or so I think. If they qualify, Medicare pays for their diabetic supplies. The glucometer, ever-so-expensive strips, lancets and all. Up to 3 tests a day for insulin users, more if necessary. And often, these things are obtained not directly from the pharmacy, but from 3rd party suppliers that are out-of-state.
Curiously enough in the last 6 months our clinic has seen more and more prescriptions from these companies, stating that our patient has requested to get supplies from them. Even more suspicious is getting 3-6 requests from different companies for our signature, for the SAME supplies, on the SAME patient. And some didn't even make sense- devices like back supports, heating pads. Things that have little to do with their diabetes.
And so sometime ago, on a hunch I began to call some patients up, asking if they really are wanting XXX supplies from YYY company. And invariably the answer is "No, I've never even heard of them", or "No I didn't ask for it, but they've been calling and bugging me".
Perchance these are honest clerical errors. But the pessimistic me thinks this is merely greedy companies trying to drain Medicare funds even more, probably contributing in a big way to medical expense here.
It's a matter I've reported to the administrators, but these faxes keep coming, and it's maddening. Human greed.
But, if nothing else, there is a silver lining to this. On a bad day when I feel that I need to vent, I've been known to call these suppliers, speak to the 'person in charge' and give them a piece of my mind. I've caught a few of them blatantly lying, like "We called Mr. X on this day" then in fact the patient denied vehemently talking to anyone. And sometimes threats of reporting them to the Medical Board quickly gets them to apologize and blame it on some misunderstanding. Ah, perks of the job.free smileys
But yes, be on the lookout- not all requests for medical supplies are real- beware!

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