HOLLEY, N.Y. – Scott Merritt received letters from Medicare detailing bills for catheters he never ordered or received, amounting to thousands of dollars in fraudulent charges.
Berkeley Brean, News10NBC: “So you didn’t need this stuff.”Scott Merritt, received Medicare statements for medical equipment: “Nope.”Berkeley Brean: “You didn’t receive it.”Scott Merritt: “Nope.”Berkeley Brean: “But Medicare is getting billed for it.”Scott Merritt: “Right.”
The letters, which state they are not a bill, list Merritt’s Medicare ID number and show Medicare paid $2,243 for 300 catheters in just one month from September to December last year.
Brean: “Just for the period of September to December of last year, it looks like they billed Medicare $6,731.”Scott Merritt: “More than that. I think it’s closer to $18,000, something like that.”
If you received statements like this, email Chief Investigative reporter Berkeley Brean at [email protected]
Special Agent Isaac Bledsoe from the HHS Office of Inspector General says the majority of catheter schemes involve stolen beneficiary information like Medicare numbers. In July, Bledsoe helped arrest 15 people, mostly from Russia, accused of a catheter scheme that billed Medicare $10.6 billion.The men were arrested and charged in federal court in the Eastern District of New York in Brooklyn.It’s called Operation Gold Rush.
“So a company will open up. They’ll enroll with Medicare. They’ll get access to beneficiary information, the provider information and then they’ll bill, sometimes for hundreds of millions of dollars in a week period,” Special Agent Bledsoe said.
Bledsoe’s team was able to stop more than 99% of the money from going out, but $41 million still slipped through. The federal Department of Health and Human Services and the U.S. Attorney’s office are now trying to recover that money through court cases.
Merritt’s paperwork shows the catheters were ordered by Sunshine Senior Solutions in Delray Beach, Florida, but the company has not returned calls for comment. The doctor named listed on the statements as having ordered the catheters is David R. Trauber, a blood disorder doctor in Brooklyn. He told News10NBC he knows his name appears on the Medicare statements but said he’s never ordered catheters.
“You get the calls every week, especially if you’re on Medicare, three or four times a day usually from some of these places are saying – how’s your pain today? Or are you having any pain?” Merritt said. “I don’t know how they got my Medicare account number. Somehow it got provided to them but they keep calling all the time.”
Special Agent Bledsoe says Medicare numbers are being sold on the dark web, Craigslist and LinkedIn.
This type of fraud was previously exposed by News10NBC in 2019, with people receiving boxes of braces they didn’t want or ask for, and their houses sometimes filled with them while Medicare was billed. Two dozen doctors, telemedicine and medical equipment owners along the East Coast were arrested in what was the largest fraud against Medicare until the catheter scheme.
If you receive an explanation of bill letter for medical equipment you don’t need and didn’t order, call the federal investigators at 1-800-HHS-TIPS.
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News10NBC Investigates: Holley man gets statements for thousands in catheters he never ordered, part of the biggest Medicare fraud ever WHEC.com.
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