Physician Was Hub in Power Wheelchair Racket, Feds Say
Written by Editor   
Tuesday, June 10, 2014 11:36 PM

There's an axiom that the single biggest driver of healthcare spending is the physician's pen, or to be up to date, the physician's mouse and keyboard. Laboratory tests, diagnostic imaging, prescription drugs, hospitalization, home healthcare, and durable medical equipment (DME) such as power wheelchairs — a physician signs off on all of them.  And sometimes not honestly.

That is the accusation facing 67-year-old Robert Glazer, MD, from Los Angeles, California, who was recently indicted in a federal district court on healthcare fraud charges. In exchange for kickbacks, said prosecutors, Dr. Glazer wrote medically unnecessary prescriptions for power wheelchairs and certifications for home care. Fraudulent claims submitted by DME and home healthcare companies, plus those submitted by Dr. Glazer for his often fictitious services, added up to $33 million from January 2006 to May 2014, according to prosecutors. Medicare paid roughly $22 million on those claims.

Power wheelchairs have been a flourishing racket for fraudsters, partly because of their wide profit margin. DME companies can buy the chairs wholesale for $900 apiece and then bill Medicare for roughly $6000, according to the US Department of Justice (DOJ).

In the first half of 2007, 9% of power wheelchairs provided to Medicare patients were medically unnecessary, whereas another 52% were based on claims with insufficient documentation to determine necessity, according to a 2011 report from the Office of Inspector General for the US Department of Health and Human Services. The government has warned beneficiaries about offers of free or dirt-cheap power wheelchairs and about advice to get a chair now for future use before Medicare runs out of money. DME companies often make good on the promise of a free chair by waiving the Medicare beneficiary's 20% copayment, which is illegal.

Another illegal practice by DME companies is giving kickbacks to patient recruiters or "marketers." Such individuals, according to the government, may approach an elderly person on the street or in a supermarket and encourage them to get a free power wheelchair. In Dr. Glazer's case, marketers operating throughout Southern California also enticed patients with gifts ranging from a kitchen blender to rice and beans, according to court records.

Both DME company owners and physicians in their networks have been routinely convicted in federal court in recent years for attempting to get rich through power wheelchair schemes. For Dr. Glazer, it was easy money, according to the government. One DME company that filled Dr. Glazer's prescriptions for power wheelchairs paid kickbacks ranging from $200 to $1000, the DOJ stated in a separate criminal prosecution. In that case, the company president was convicted of Medicare fraud and sentenced to14 months in prison.

Source:  http://www.medscape.com/viewarticle/826386?nlid=58943_2841&src=wnl_edit_dail