Medical Devices and Supplies
Background
Common Medical Device and Supply Fraud Schemes
Providers of medical devices and supplies have engaged in all manner of schemes to defraud federal health care programs. Some of the most common include:
- Supplying beneficiaries with products they never ordered.
- Shipping higher quantities of a product than what the beneficiary ordered.
- Providing medical devices or supplies without proof that the beneficiary had any medical need for them.
- Automatically refilling supplies without verifying that the beneficiary still has a need for them.
In some extreme cases, criminal organizations have stolen beneficiary data and used it to fake prescriptions and place orders for Medicare-covered products without ever communicating with the beneficiaries at all.
Medical Device Fraud and the Anti-Kickback Statute
As in the Arriva case, schemes to push customer orders and refills will also sometimes run afoul of the federal Anti-Kickback Statute. Under the Medicare Program, beneficiaries typically pay a co-pay for covered medical devices and supplies (which is often 20% of the total amount). Suppliers looking to bill the United States for items that a beneficiary never ordered or did not need may write off such co-pays to avoid the beneficiary raising complaints about the scheme. While Medicare permits co-pay waivers based on individualized showings of financial hardship, routinely writing them off constitutes an unlawful kickback and a violation of the FCA.
Medical device and supply fraud is one of the more pervasive types of healthcare fraud in the United States, and our firm has the experience and track record to assist whistleblowers in bringing these schemes to light.