Call your health care provider and talk to him or her about this scam. You can also call the Medicare fraud hotline at 800-633-4227 (800-MEDICARE) or file a complaint at the Better Business Bureau Complaints page. Get in touch with Senior Medicare Patrols at 877-808-2468 or smpresource.org.
How does the Medicare back brace scam work?
for processing claims from orthotists and prosthetists for artificial limbs and braces, commonly called orthotics and prosthetics (O&P). In the event of a claim review, the O&P supplier may request your medical records, in addition to providing their notes to the Medicare contractor.
Why did I get a brace from Medicare?
Jul 30, 2021 · Updated on September 27, 2021. Medicare approves braces and devices when medically necessary to treat or maintain a medical condition. Orthotic devices like braces are otherwise known as Durable Medical Equipment. Braces may be used to support the knee, neck, arm, or back. Combining the use of orthotic devices with other treatments may delay ...
Does Medicare cover braces and devices?
1-800-MEDICARE (1-800-633-4227) or. The U.S. Department of Health and Human Services – Office of the Inspector General. Provider fraud or abuse in a Medicare Advantage Plan or a Medicare drug plan (including a fraudulent claim) 1-800-MEDICARE (1-800-633-4227) or. The Investigations Medicare Drug Integrity Contractor.
Do you qualify for a back brace from Medicare?
Nov 24, 2020 · You can also call the Medicare fraud hotline at 800-633-4227 (800-MEDICARE) or file a complaint at the Better Business Bureau Complaints page. Get in touch with Senior Medicare Patrols at 877-808-2468 or smpresource.org. You can report the fraud as well to the FBI at 1-800-Call-FBI.
Is a leg brace a DME?
Comfort, non-therapeutic cast-braces are considered medically necessary DME after a fracture or surgery.
Does Medicare cover Arizona brace?
In most cases, the Arizona AFO is covered by Medicare reimbursement when prescribed by a physician for approved applications. However it is the patient's responsibility to verify coverage and secure any necessary pre-approvals.
Will Medicare pay for a foot brace?
Does Medicare Cover Foot Braces? A foot or ankle injury may require you to use a foot brace. Coverage is available if your doctor documents it's medically necessary. Foot braces may be custom or standard – coverage is available for both.27 Sept 2021
Does Medicare cover AFO braces?
Ankle-foot orthoses (AFO) and knee-ankle foot orthoses (KAFO) are covered under the Medicare Braces Benefit (Social Security Act §1861(s)(9)).
What is an unloader brace?
Unloader braces limit the patient’s side movements, forcing patients to avoid using the areas of the knee joint affected. Prophylactic – the most common type of knee brace for athletes. High-risk or injury-prone individuals may also need to wear this brace for support.
What is wrist support brace?
Wrist support braces are another type of Durable Medical Equipment. Benefits include all wrist supports, braces, and stabilizers. Wrist supports may provide some pain relief due to medical conditions such as tendonitis, carpal tunnel syndrome, and other wrist strains or sprains.
What is Part B insurance?
Part B covers 80% of the approved amount for Durable Medical Equipment, vaccinations, and therapeutic services. A prescription from your doctor is generally adequate for coverage. However, in some situations, Medicare may require prior authorization before paying for Durable Medical Equipment.
Who is Lindsay Malzone?
Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.
Why do people wear back braces?
Back braces are often vital when treating compression fractures and relieving acute and chronic pain. Back braces help treat a wide range of conditions, and your plan likely covers the cost. Commonly, treatments include post-surgical procedures. ‘.
What is an orthotic device?
Orthotic devices like braces are otherwise known as Durable Medical Equipment. Braces may be used to support the knee, neck, arm, or back. Combining the use of orthotic devices with other treatments may delay the need for a surgical procedure. Benefits and prices may vary among plans. Costs may also change depending on where you purchase ...
What does Part B cover?
Part B covers 80% of the approved amount for Durable Medical Equipment, vaccinations, and therapeutic services.
How to report Medicare fraud?
You can also call the Medicare fraud hotline at 800-633-4227 (800-MEDICARE) or file a complaint at the Better Business Bureau Complaints page. Get in touch with Senior Medicare Patrols at 877-808-2468 or smpresource.org. You can report the fraud as well to the FBI at 1-800-Call-FBI.
How much did Medicare fraud cost?
If you do so, you can expect that they will use it to bill Medicare for the equipment. Medicare fraud is very prevalent as it has cost around $60 billion. Only in April 2019, 24 people across the country reported or were the victims of DME fraud, which cost approximately $1.2 billion.
How to protect yourself from criminals?
First, it is necessary to reject the offers and notify the authorities about this attempt. You need to report people who offered you “free” equipment and asked you for your Medicare number. See below how.
What is a brace?
Braces are defined in this section as “rigid or semi-rigid devices which are used for the purpose of supporting a weak or deformed body member or restricting or eliminating motion in a diseased or injured part of the body.”.
What is OTS orthotics?
Section 1847 (a) (2) of the Act includes OTS orthotics as one of the categories of items subject to competitive bidding. CMS has not determined the schedule for bidding OTS orthotics, but will identify the specific OTS orthotic codes included in a competitive bidding program through program instructions or by other means, ...
What is an OTS code?
Off-The-Shelf (OTS) Orthotic HCPCS Codes. Section 1847 (a) (2) of the Social Security Act (the Act) defines OTS orthotics as those orthotics described in section 1861 (s) (9) of the Act for which payment would otherwise be made under section 1834 (h) of the Act, which require minimal self-adjustment for appropriate use and do not require expertise ...
How to report Medicare fraud?
If you get one of these calls, immediately hang up. Here are some other steps you can take: 1 Call your doctor and tell him or her about the attempted scam 2 Call the Medicare fraud hotline: 800-633-4227 (800-MEDICARE) 3 File a complaint at BBB.org/complain 4 Get help from Senior Medicare Patrols: 877-808-2468 or smpresource.org 5 Report the fraud to the FBI at 800-Call- FBI
How many people were indicted for DME fraud?
In April 2019, the U.S. Department of Justice indicted 24 people across the country for DME fraud involving more than $1.2 billion in losses. And here’s one more reason to care about durable medical equipment fraud: if you receive an unnecessary piece of equipment but don’t report it, you may be stuck later.
Is Medicare back brace a scam?
Scam Alert: Beware of the Medicare back brace scam. By Better Business Bureau. May 28, 2020. (Getty) The Better Business Bureau is hearing from consumers who have been targeted by scammers for “free” back braces.