Troubleshooters Investigation: Health Care Scheme

Many of us are protective of our aging parents and Michele Sherry is no exception.

Sherry reached out to the Troubleshooters after her 82-year-old mother received a number of orthotic braces in the mail after a telemarketer called her.

"She has some mobility issues as far as walking because she has scoliosis," Sherry said.

But, what troubled her was that her mother was never examined for the braces and she said believed they were free.

Sherry shared the recording of that telemarking call with the Troubleshooters:

"My name is Sarah and I am from pain relief center. I understand that you're having discomfort in your lower back and in your both knees sometimes, correct?" said the caller.

"Correct," Sherry's mother Joan Parno replied.

"And you are interested to receive a brace to ease that pain, right?" said the caller.

"Yes," said Parno.

Sherry said soon afterward, her mother received three knee and back braces from three different companies.

"I said who's paying for this? She told me they were free," Sherry said.

But after doing some digging, Sherry quickly learned that those braces were not free.

Both Medicare and Parno's insurance were billed $3,395.

"I think its fraud and I think it's an absolute disgrace," Sherry told the Troubleshooters.

The Troubleshooters learned the doctors who prescribed the braces aren't orthopedic specialists.

One is a neurologist.

The other is a urologist and neither ever met or examined Sherry's mother.

"I think it's really odd that a urologist would be prescribing orthopedic equipment for my mom without even seeing her and knowing here that was like a red flag for me," Sherry added.

The Troubleshooters tracked down one of those doctors, who wrote a script.

Dr. Vance Moss, the Urologist who has been profiled on ABC News and has appeared on the syndicated show, The Doctors.

The Troubleshooter's asked Dr. Moss if he had any expertise in orthopedics and he told us he did not.

We also asked why as a Urologist he prescribed the knee and back braces.

Dr. Moss told the Troubleshooters, "The purpose of going into this tele-med program we were trying to learn the platform."

He also said he wanted to use telemedicine to help his own patients and any physician can evaluate a patient for an orthotic device, as long as Medicare criteria is met.

Moss resigned from the tele-med company after Parno's daughter confronted him about his prescriptions being used by multiple companies.

The doctor claims even after his short months-long experience, he now believes he was part of a scam.

Federal investigator Stanley Rutkowski is unfamiliar with Parno's case but said durable medical equipment scams involve kickbacks.

"This is one of the largest health care fraud schemes that have been going on in recent history," Rutkowski said.

Rutkowski explained how the scheme works.

According to Rutkowski, the call center gets doctors to write the prescriptions and then the owners of the telemedicine companies give those doctors a kickback, usually money.

In April, the FBI charged 24 people with brace-related scams that bilked Medicare out of 1.2 billion dollars.

"And who has to pay for it?" said FBI Assistant Special Agent in Charge.

"Our parents who have to pay rising medical costs as do we," he added.

TROUBLESHOOTER TIPS:

According to Medicare, the scheme can hurt beneficiaries.

There are limits on some services so if it appears you've already received braces, for instance, you might not be able to get them when you really need them.

Medicare said it's important to protect your Medicare number just like you would your social security or bank account number.

And, if you get a call from a telemarketer asking for your personal information, hang up.

And if you get a package for braces you didn't order, do not accept the package.

Take a picture of the label and reach out to the HHS or FBI fraud hotlines.
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