Fleecing of our government: Durable medical equipment

One of the latest Washington scandals is that school and
government officials have been in league with some student loan companies to
steer student loan applications to them. 
[Washington Post: Education
Dept. Places Official on Leave
, April
6, 2007; Hopkins
Official Implicated as Student Loan Investigation Widens
, April 10, 2007]

Why do these loan companies strive so hard to lend money to
students that they abandon ethical behavior? 
Because it is a source of big profits. 
According to Senator Kennedy, "The student loan program works
brilliantly for the banks, but not for the students," [Washington
Post, April 2, 2007; Page D01
] 

Have you seen ads on
TV offering motorized wheel chairs and scooters to Medicare patients who need
assistance to get around?  The ads
include inducements such as, “If you qualify, we will take care of all the
Medicare paperwork and you may need to pay nothing at all.”  It costs money to run those ads.  Presumably, if someone has a medical
condition his or her doctor or social worker would provide advice on what the
options were and how to apply for them. 
TV ads should not be needed.  I’m
guessing that the reimbursements are so generous that it pays for the companies
selling the scooters to advertise.  My
guess is they are going after people who might not truly require such motorized
transport, but can get a cooperative doctor to sign the form anyway.

I have diabetes and
use a mail order company to supply me with glucose testing supplies.  I’m very happy with the service I get from
the company I chose, Liberty Medical. 
But their, and their competitors’, eagerness to solicit new orders makes
me suspect that the government is being overly generous in its
reimbursements. 

Because of my
diabetes, a podiatrist ordered special therapeutic shoes for me, covered
entirely by insurance.  I don’t know but
I suspect that podiatrist either has a financial interest in the shoe company
or is getting kickbacks from it.  

The Medicare Part B
program covers a sizable chunk of most outpatient expenses such as physician
visits, x-rays, and lab analyses. 
Medicare Part A t
ypically pays for your inpatient hospital
expenses.  But both Part A and B also
cover durable medical equipment, and reimburses wheelchair and diabetes testing
supplies.  So although the Medicare Part B program is so miserly on its
reimbursements to physicians and other health care providers that some opt out
of the program and won’t accept Medicare patients, the durable medical
equipment program possibly is overly generous in its reimbursement for those
medical devices for which competitors are scrambling for larger shares of the
business. 

So both the student
loan program and Medicare reimbursements for durable medical equipment appear
to have been so generous that they have companies relaxing their ethical
standards to increase their share of the money pot.  The difference is, the Congress is now on to the student loan
companies, but has not paid attention yet to durable medical equipment. 

I may be wrong on that last point.  It turns out
that Medicare itself is aware of fraud in some durable medical equipment claims.  It has issued a pamphlet, Publication 11046,
Protecting
Medicare’s Power Wheelchair and Scooter Benefits
.”  It tells Medicare patients to be wary of
offers for power scooters.  Why treat
the problem this way?  Why not just
regulate the TV advertisements of these companies?  Make it a condition of Medicare reimbursement in order to avoid free speech issues.  That is, allow them to advertise all they want, but the government deny Medicare reimbursement to companies who solicit Medicare business.  Congress, are you listening?

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