Medicare at forefront of treating erectile dysfunction...in females

 - 
08/16/2010

Do you ever feel bad for the hardworking providers in South Florida? The ones that are aboveboard and honest who seem to spend as much time battling negative image as they do selling home medical equipment?

I mean, when Medicare contributes to the fraud problems in the area, what's a provider to do? In the latest fraud news from the sunshine state, Medicare paid out $28,600 in false claims for, uh, penis pumps. Yes, they are a covered item (at $395 at, ahem, a pop). But not for females. I mean, what's the diagnosis code for that?

As reported in the Miami Herald:

Emilio Felipe Lopez, 47, president of Charlie RX, and Orlando Hernandez Estevez, 25, president of Happy Trips, were indicted on charges of healthcare fraud in February. Last week, FBI agents arrested the two Hialeah businessmen.

Both defendants are accused of stealing Medicare patients' numbers and doctors' identifications to submit nearly $2 million in bogus bills to the healthcare program for the elderly and disabled between October and February.

Lopez's company, Charlie RX, billed Medicare a total of $689,853 in phony claims for medical equipment, including $41,000 for penis pumps for both male and female patients, according to authorities. Medicare reimbursed his business $370,853, including $24,000 for the pumps.

Hernandez's company, Happy Trips, submitted $1,188,956 in false claims for inhalation drugs and other medical services, including $22,000 for the erection systems, officials say. Medicare paid his business $364,120, including $4,600 for those systems.

Tags: