Medicare Fraud Scheme Unfolded by Pulse Oximeter Industry

ROCKVILLE, MD, September 13, 2011 (Press-News.org) It was recently announced that the Justice Department of the United States officially charged 91 persons for Medicare Fraud, which equated to $295 million of loses to the American taxpayer. The 91 people charged included doctors, nurses, and other medical professionals. The scheme was nationwide ranging over eight cities. The scheme was based on false billing. Attorney General Eric Holder led the efforts, stating that the persons charged were jeopardizing the integrity of our health care system and our nation's most critical health care programs for personal gain. The charges included, but were not limited to, conspiracy to defraud the Medicare program, health care fraud, violations of the anti-kickback statutes, and money laundering. If that is not shocking enough, the scheme involved home health care, physical and occupational therapy, mental health services, psychotherapy, and durable medical equipment services. The arrests and charges were a surprise to many people both outside and within the healthcare industry. Many people put blame on the Medicare program as well. They have stated that the program is not managed properly, and it has allowed for people to take advantage of it for years now. Even though 91 people have been charged, it has been universally understand that many more people have abused the Medicare system and will proceed unpunished.

The pulse oximetry industry could be considered as a whistle blower. A pulse oximeter, also known as a pulse ox, is a medical device used to measure blood oxygen saturation and pulse rate of an individual. A pulse oximeter for many years was not covered under Medicare programs, even though a prescription was required for obtaining certain kinds. The pulse oximeter industry was baffled by how they were not covered by Medicare, while other products were. The misconnection and unclear rules lead the pulse oximeter industry to raise their hand and question the Medicare program. Their questioning was one of many reasons the Attorney General got interested in the claims and the program. People from within the pulse oximeter industry, stated they know that many thousands of people require a pulse oximeter but cannot afford one. It is absolutely astonishing that these people were denied a necessary medical device, when many other non vital devices were offered by the Medicare program.

The recent charges bring the spotlight to the Medicare program. Many people hope the charges will help bring necessary changes to a program that is out of date.

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