In March, a large cardboard box appeared on Keith Kells' doorstep. One month later, another box showed up.
Both were filled with orthotic braces that the 85-year-old University City, San Diego, resident said he does not need and never ordered. It was a similar story for Edith Green, 82, of New Jersey who received a big box filled with 20 braces from a San Diego company despite telling the telemarketers who called over and over that she didn't want them.
Separated by more than 2,700 miles, the two Medicare beneficiaries both reported their experiences to federal government hotlines at Medicare and the U.S. Office of Inspector General, which has recently become very interested in the number of boxes filled with braces showing up on doorsteps across the United States.
For Kells, the first box, from a company called Bracing Partners in Largo, Fla., arrived after a barrage of telemarketer phone calls telling him that, as a Medicare beneficiary, he was entitled to these medical supplies. Though he insisted he didn't want them, and didn't need them, the devices showed up anyway.
The second box was from EZ Life Medical Supply in Escondido which, Kells said, never contacted him before sending a single large back brace.
Green said her box was filled with about 20 different medical braces for every part of her body from foot to shoulder. They arrived, she said, even after she used a choice swear word demanding that the consultants stop calling her.
Despite returning the box to San Diego-based C&E Medical Devices Inc., Green said she still received a benefits summary from Medicare that told her the program had paid $3,000 for the braces on her behalf and she still owed $541.
Though her bill hasn't yet been reversed by Medicare's fraud division, Green said she's upset there are companies bilking a very important program that most will rely on once they turn 65.
"I'm angry, personally, that they had the balls to do this, but I'm also angry because Medicare is in a lot of trouble financially, and I'm not sure if it's going to be around for my grandkids to use when they need it," Green said.
The federal government began to fight back on April 4, filing a flurry of lawsuits in six different states that charge 24 people for being involved with 130 different durable medical equipment companies. Government investigators allege they are collectively responsible for $1.7 billion in fraudulent Medicare claims for braces that were not medically necessary.
Billed by the U.S. Office of Inspector General as "one of the largest health care fraud schemes in U.S. history," the indictments accuse companies of contacting hundreds of thousands of seniors, spanning international borders by using call centers sometimes located in the Philippines and Latin America.
According to prosecutors, medical device companies paid doctors for brace prescriptions after they conducted brief telemedicine examinations with patients they had never met, billing Medicare, then kicking back part of the reimbursement they received to the prescribing doctors.
The current set of indictments includes one filing in the Central District of California and another in the Middle District of Florida, but neither filing included Bracing Partners, EZ Life Medical Supply or C&E Medical Devices Inc.
Both Kells and Green said they received no doctor consultations before shipments arrived on their doorsteps. Like Green, Kells, a retired engineer, noted that the shipments were somewhat absurd. Having decided to keep his two boxes as "evidence," Kells pulled out a leg brace from the largest carton, holding it up in front of his face.
"Just look at this thing, it's too small to fit one of my clod hoppers anyway," he said.
None of the three companies returned calls for comment on the shipments. But there are signs that, despite the recent federal indictments, big boxes full of medical braces are moving across the country.
The first box that Kells received, the one sent by Bracing Partners in Florida, has a return address in a Kearny Mesa office park. The suite listed on the box is occupied by a shipping returns center run by a company called EverPrime Concepts. Friday afternoon, the business's front window was entirely filled with unmarked brown cardboard boxes. Inside, more identical boxes were stacked floor to ceiling. An employee who declined to give his name said the boxes were full of braces, but not necessarily from Bracing Partners.
The status of the three companies that sent Kells and Green their braces is unclear. A spokesperson with the Office of Inspector General in Washington said the organization is aware of the companies due to the reports that both of them made to the organization's fraud hotline. But he said it is OIG policy not to comment on the existence of any ongoing investigations.
Micki Nozaki, director of the Sacramento-based California Senior Medicare Patrol, said her office was getting non-stop calls from seniors who had received unwanted braces last year when promotions ran on late-night television. The brace complaints died off right before the federal indictments dropped in the spring, replaced by complaints of fraudulent billing associated with hospice and genetic testing scams. Recently, though, brace calls seem to be picking up again.
"I'd say the brace stuff has picked up in May and June. I think it's pretty much like whack-a-mole," Nozaki said.
While seniors might be tempted to simply send the unwanted braces back whence they came and ignore any bills that arrive in the mail, the consumer advocate said that doing so means that, should they ever need a brace for a truly legitimate medical reason, Medicare may deny the claim.
"They may say, 'we're not going to approve it, because your record shows that you have already received that benefit,'" Nozaki said.
Once a person's Medicare identification number is circulating among these companies, she added, it may be bought, sold and used for other dubious services. Luckily, a recent change to Medicare's numbering system allows any senior who suspects their number has been compromised to request a new one free of charge. Nozaki said her office will work with any senior in the state to request a new number and also operates a fraud line that regularly helps seniors forward complaints to the proper authorities. The hotline is: (855) 613-7080.
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