Wheelchair scam fastest-growing one in Medicare

WASHINGTON - Euralda Clodomar doesn't own a wheelchair, let alone the motorized model that was charged to Medicare at a cost of $3,840.

An equipment supplier had obtained the 85-year-old's Medicare identification number and taken her and the taxpayers for a ride in a fast-growing new swindle that has cost the government's main health care assistance program tens of millions of dollars.

Fifty investigations under way in nearly two dozen states, including Florida, have identified $167-million in fraudulent power wheelchair claims, officials say.

"It certainly is the fastest growing scam in Medicare," said Dara Corrigan, acting inspector general in the Department of Health and Human Services. "It's about a wheelchair that is very expensive and about people trying to make a profit."

The medical equipment industry has aggressively marketed its electric wheelchairs, particularly in television ads targeting senior citizens. The number of Medicare beneficiaries with at least one claim for a motorized wheelchair rose from about 55,000 in 1999 to 168,245 in the first nine months of this year.

Part of the increase can be explained by improvements that allow the wheelchairs to turn in a small radius. But an industry group, the Power Mobility Coalition, agrees some claims result from fraud and it supports the government crackdown, "Operation Wheeler Dealer."

Medicare's crackdown has recovered $52.5-million. New suppliers have been banned from enrolling in the program, prosecutors have been ordered to bring cases quickly and officials are poised to stop payments. Medical personnel must certify they've seen a patient before prescribing a motorized wheelchair.

Investigators say the cases can include:

Equipment company suppliers who submit phony claims.

Doctors who take kickbacks for writing prescriptions.

People who roam shopping malls offering free medical equipment to anyone who will sign up for a wheelchair.

Conspirators who stage fake deliveries, complete with pictures of patients who pose with their power chairs for a fee.

Medicare can pay 80 percent of the cost of motorized wheelchairs and the rest is often covered by other insurance companies. Some suppliers, investigators said, have charged Medicare for power wheelchairs costing $5,000 or more while providing cheaper motorized scooters.

Elizabeth Bostick, 89, of Ocala and her late husband were approached by a saleswoman who represented medical equipment companies. The parent firm, Gold Star Healthcare, billed Medicare $15,500 for two motorized wheelchairs, a hospital bed, a pressure mattress and other equipment for the couple, who said they didn't need any of it.

The government says Gold Star looted Medicare of millions from 1995 to 1998, when agents raided its Tampa offices and arrested president Barry Douglas Haught on fraud charges.

"They had too much pressure on me," said Bostick, who was surprised when two red, motorized scooters arrived. "I was wondering how it could have come. I thought a doctor had to give you one," she said. "There was nothing wrong with him, and there wasn't anything wrong with me."

Medicare's 80 percent share for power wheelchairs grew from $22.3-million in 1995 to $663.1-million in 2002. That total has been surpassed in the first nine months of 2003.

Corrigan said fraudulent operators often try to scare seniors.

"They'll say to the beneficiary, "You may not need it now, but you know how Medicare is going. Medicare might be out of money in a few years,' " she said.

© 2006 • All Rights Reserved • St. Petersburg Times 490 First Avenue South • St. Petersburg, FL 33701 • 727-893-8111 Contact the Times | Privacy Policy Standard of Accuracy | Terms, Conditions & Copyright