Action 9

Use of telemedicine can lead to increase in insurance billing abuse

Action 9 has a warning about aggressive telemarketers who target people staying at home because of COVID-19 and depend on telemedicine for care.

“I got up to 5 calls a day and they became more and more intense. I said the calls have got to stop,” Sharon Jones said.

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Jones says the same telemarketers kept calling, claiming they worked for Medicare.

“felt as though they would go away if I kept ignoring, kept hanging up,” Jones said.

She says it was bizarre that they wanted to send free knee braces for a medical condition she doesn’t have.

“I said don’t need the product, don’t want the product, and he said well that’s how to get them to stop,” Jones said.

She heard; they would only stop calling if she accepted a free product. So, Sharon played along without giving them any billing information.

“One of the things I had to say was that my knee joints are higher than 50% disabled. He said that’s how you get the braces. And I said I don’t want them,” Jones said.

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The company stopped calling but a month later, Jones received knee braces, even though she never had a doctor’s prescription and didn’t share her Medicare billing information.

Then she received a letter from Medicare. A company called Reliable DME in California, billed her account more than $2,400 and the government paid the company $1,500.

“I’m just one person and you saw that bill. No wonder Medicare has financial difficulties,” Jones said.

Action 9 checked; every month Medicare receives 600 complaints a month involving telemarketers finding victims then paying doctors to write phony prescriptions.

Medicare fraud expert Louis Saccoccio with the National Health Care Anti-Fraud Association says the call Jones got is a new extreme.

“In this case you had a real, very aggressive type situation, where it’s almost like unless you do what we tell you to do we won’t stop calling, and that is pushing the envelope,” Saccoccio said.

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Just last year, a federal raid shut down a $1.2-billion scheme to ship free braces. 24 people including three licensed doctors were charged with fraud.

Now with many seniors relying on telemedicine because of Covid-19, experts think medical telemarketing scams will find many new victims.

“Patients become more open to the fact someone may be calling them for some reason about their healthcare,” Saccoccio said.

Medical equipment suppliers like Reliable DME have blamed controversial sales on independent telemarketing companies that make the sale.

Reliable DME has not returned any of Todd Ulrich’s phone calls.

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Jones tried to return the braces and complained to Medicare.

“Just stop them,” Jones said.

Telemarketers are also offering free Covid-19 testing and treatments to find new victims. But be careful, doctors will never call asking for Medicare or any insurance information to sell new treatments.

Todd Ulrich

Todd Ulrich, WFTV.com

I am WFTV's Action 9 Reporter.