While Medicare offers users a variety of ways to receive the outstanding health care they deserve, there are still instances of people taking advantage of the system. That is why it is important to be aware of fraudulent schemes and scammers who are not only getting away with cheating the system, but receiving handsome paychecks as well.
Chiropractic services, or any manipulation to the spine, are covered under Medicare Part B if proven to be medically necessary, as well as provided by a licensed chiropractor or other qualified provider. In alliance with other areas of coverage, Part B will take care of 80 percent of all cost while you are responsible for the remaining 20 percent. While these are the standard guidelines toward receiving coverage over chiropractic services, it is also important to note that who you are obtaining treatment from could be illegally collecting Medicare funds while not owning a proper license.
In a recently released report issued by the Centers for Medicare and Medicaid Services, licensed chiropractors all throughout the U.S. received nearly $500 million in funding for treatments. One of the people who was wrongfully benefiting from these payments was Michael Kelly Miller, who owned a therapeutic clinic called Waldo Rehabilitation Health & Wellness in Kansas City, Missouri, in 2009 through 2011. Miller has recently pleaded guilty to one count of health care fraud, admitting that he submitted numerous fraudulent Medicare claims for nerve-block injections totaling more than $3 million.
The injections in question that were provided by Miller were not medically necessary for the patient's health, which is a clear cut violation of Medicare coverage policy. Miller is now required to pay at least $879,582 in restitution to the government, which is the same amount he received from Medicare for all the unwarranted injections he administered. On top of the fees, Miller is facing between serving 15 and 21 months in federal prison, and is currently awaiting a final sentencing.
The importance of reporting fraud and abuse
Someone who is illegally receiving benefits and payment from Medicare is not only hurting themselves and the system, but they are having an impact on everyone who uses their policies for all their medical needs. Medicare loses billions of dollars in fraudulent claims everywhere, which is why reporting fraud and abuse is essential for maintaining an ideal healthcare institute. Examples of committing Medicare fraud include:
- Health care providers billing Medicare for equipment or services you have never received
- People or companies using false or misleading information to persuade you into joining a Medicare plan
- Being offered a Medicare drug plan that has not been approved by Medicare
- Handing out your Medicare card to someone else to get medical care, supplies or equipment
The best way for reporting fraud is by calling 1-800-MEDICARE. By helping Medicare fight back against scammers, you could be eligible to receive upwards of $1,000 for your assistance. Help everyone, including yourself and keep an eye out for Medicare fraud and abuse.