NBC 5 Responds: Medicare fraud case leads to federal action ...Middle East

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Doug Wilmoth thought he was just checking his routine Medicare statement. Instead, he discovered more than $32,000 in charges for medical supplies he said he never ordered.

“Total is $32,880 for supplies that I didn’t get, I didn’t ask for, I didn’t need,” Wilmoth told NBC 5 Responds.

The charges included urinary catheters, wound covers, and sterile pads — all billed to Medicare by a Florida company called Sunshine Senior Solutions.

Wilmoth called the company directly. He said representatives told him they had no record of him as a patient and denied submitting the claims. He filed a fraud complaint with Medicare, but months later, another statement arrived showing even more payments to the same company.

Frustrated, Wilmoth contacted NBC 5 Responds.

NBC 5 Responds Investigates

NBC Chicago reached out to Sunshine Senior Solutions by phone and email but received no response. Our partners at NBC South Florida visited the company’s office in Palm Beach County. They knocked on the door and heard movement inside, but no one answered.

The Centers for Medicare and Medicaid Services (CMS) confirmed to NBC Chicago that Sunshine Senior Solutions is no longer enrolled in the Medicare program as of June 2025.

In a statement, CMS said it uses “advanced data analytics, beneficiary complaints, and referrals from providers, states, and law enforcement to identify potential fraud, waste, or abuse.” The agency added that it can suspend payments, revoke billing privileges, or refer cases to law enforcement.

Palm Beach County’s consumer protection office also confirmed it received a complaint about Sunshine Senior Solutions and referred the matter to local and federal authorities.

What You Can Do

Medicare advises anyone who suspects fraud to report it by calling:

1-800-MEDICARE HHS OIG Hotline: 1-800-HHS-TIPS

 “It’s like a slap against the United States of America,” Wilmoth said.

He hopes his story encourages others to check their billing statements closely.

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