October 1, 2020

Beware of offers for “free” braces covered by Medicare.  Scammers are broadcasting TV commercials or contacting Medicare beneficiaries by phone to offer “free or low cost” knee, back and other orthotic braces. Scammers will use your Medicare number to charge Medicare.

Here’s an example of one such operation that has been stopped.

According to charging documents, Jones and Putulin conspired with Juan Camilo Perez Buitrag to submit more than $109 million in false and fraudulent claims for durable medical equipment (DME) such as arm, back, knee and shoulder braces. Perez was charged in July 2020 and has agreed to plead guilty. A plea hearing for Perez is scheduled for Oct. 5, 2020.

It is alleged that Jones and Putulin helped Perez manufacture and submit false and fraudulent Medicare claims by establishing shell companies in more than a dozen different states, including Massachusetts. Perez directed employees, including Jones and Putulin, to list his mother, wife and yacht captain as corporate directors and to use fictitious names when registering the shell companies as DME providers. At Perez’s request, Jones and Putulin allegedly purchased Medicare patient data from foreign and domestic call centers that targeted elderly patients, and instructed call centers to contact the Medicare beneficiaries with an offer of ankle, arm, back, knee and/or shoulder braces “at little to no cost.”  Perez then submitted Medicare claims for those patients without obtaining a prescriber’s order to ensure that the braces were medically necessary. It is further alleged that he submitted blatantly fraudulent claims, including claims for deceased patients and repeat claims for the same patient and the same DME. Perez failed to provide any DME for more than $7.5 million in claims. When Perez did provide DME to patients, he typically billed insurance policies more than 12 times the average price of the DME that he provided to the patient.

Read the full story.

Source: Department of Justice