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Medical Equipment Scam

Brace Fraud

Medical equipment scams and fraud often go "under the radar" because no medical equipment is delivered, and the items can be easily missed in an Explanation of Benefits (EOB).

How the Scam Works

  • A fraudulent Durable Medical Equipment (DME) company approaches a fraudulent physician, or uses an unsuspecting physician's stolen identity, to medically certify that a beneficiary needs supplies.
  • This same fraudulent DME company may also have stolen, or otherwise purchased Medicare beneficiary numbers and begin to fraudulently bill Medicare for goods.
  • Typically no actual equipment is delivered to the beneficiary. The beneficiary may not know equipment is being billed in their name but not delivered.
  • In other schemes, a fraudulent DME company may offer the Medicare beneficiary meals or food in exchange for their Medicare number. The DME company may also provide the beneficiary with nutritional supplements. Be aware that Medicare only pays for nutritional support when the beneficiary has a feeding tube in place.
  • Other common costly DME items that are offered include "custom" diabetic shoes, oxygen, nebulizers, and therapeutic mattresses.  We commonly see back braces falsely used as medical equipment.
  • Sometimes the beneficiary is aware of the fraud and is paid a "kickback" in cash for selling his Medicare information.

How to Fight Back

  • Do not let anyone except your physician's office handle your Medicare card. If anyone other than your physician's office requests you to provide your Medicare information, do not provide it.
  • Never accept "free" medical equipment or services in exchange for your Medicare number.  Nothing is ever free.
  • Don't trust TV ads promoting free back braces or mailing inserts with "free" offers.
  • Review your Explanation of Benefits (EOB) paperwork for items that appear that you did not order or receive and report any discrepancies immediately.

Contact the Iowa SMP if you have been approached or contacted by anyone you suspect to be a scammer
at 1-800-351-4664 (TTY 1-800-735-2942).