The Missouri SMP presents the September Fraud Fact

Date: September 11, 2017 | Category: News

For the fraud fact this month, we are going to tell you how to handle some of those pesky marketing calls and direct mail letters you get – this time from someone trying to sell you a so-called Medicare approved back brace.
Be wary when you get a call, and the salesman says you have been approved to receive a back brace at no cost to you. You need to discuss your needs for such items with your primary care physician or specialist who is taking care of your specific health. A back brace is not something you buy off a post card, phone call or late-night TV.
Medicare Part B does cover medically necessary durable medical equipment that your doctor prescribes for use in your home. But only your doctor can prescribe medical equipment for you. Say no to cold-call salespeople.
An item such as a back brace is considered durable medical equipment if it meets these criteria: It can withstand repeated use. It’s used for a medical reason. It’s NOT useful to someone who is NOT sick or injured. It’s used in the home and is expected to last at least three years.
Part B of original Medicare will cover it. If your supplier accepts assignment, you pay 20 percent of the Medicare-approved amount, and the Part B deductible applies. Medicare will only cover your equipment IF your doctors and suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to stay enrolled in Medicare.
As always, report suspected Medicare fraud to the Missouri SMP at (888) 515-6565. SMPs are funded through the U.S. Department of Health and Human Services, Administration for Community Living, Administration on Aging.