What's the real story about fraud?

Stakeholders respond to Post story, 'A Medicare scam that just kept rolling'
Friday, September 26, 2014

WASHINGTON – A recent story in the Washington Post highlighting power wheelchair fraud is simply rehashing old news at the cost of highlighting current problems, industry stakeholders say. 

“A Medicare Scam That Just Kept Rolling,” which appeared in the Aug. 16 issue of the newspaper, looks back five to 10 years, and focuses on people who started businesses with the sole purpose of defrauding the government, said Don Clayback, NCART executive director. 

“You can tell these are not all legitimate medical supply companies,” he said. “It’s a few bad apples in the article versus thousands of dedicated companies.”

The Post story was part of a short series on problems with the Medicare program.

Stakeholders also point out that the fraud reported on in the story, like with other stories in the mainstream press about power wheelchair fraud, happened before CMS made certain policy changes in the mid-2000s to reduce fraudulent activity.

“The way Medicare had the program set up, they allowed a lot of this to happen,” said Dan Fedor, compliance director with The VGM Group’s U.S. Rehab. “They didn’t watch this closely enough and brush stroked everybody.”

The majority of providers are just trying to do the right thing, stakeholders say. By way of proof, they point out that current statistics show technical errors, not fraud, are responsible for many power wheelchair denials. 

Instead of examining what happened 10 years ago, attention needs to be paid to current problems with the Medicare program, like decreased access to complex rehab, says Weesie Walker, NRRTS executive director.

“The consumers are frustrated but don’t know what to do to bring about the awareness,” she said. “Wouldn’t this be a great story for the Washington Post? Perhaps it is not as juicy as the scam story.”