The HHS Office of Inspector General (HHS-OIG) has issued a warning to the public about a fraud scheme that targets Medicare enrollees and involves them setting up monthly payments for medically unnecessary remote patient monitoring (RPN). Scammers are cold calling Medicare enrollees, sending unsolicited text messages, and using Internet and television ads to push RPN services, regardless of medical necessity. RPM is a legitimate service of benefit to individuals who have medical conditions such as diabetes that can deteriorate quickly, resulting in complications, hospitalization, and even death. RPN involves remotely monitoring patients to identify anomalies such as an irregular heartbeat, high blood pressure, or dangerous blood glucose levels, allowing rapid action to be taken before a condition deteriorates. RPM typically involves glucose monitors, blood pressure cuffs, and cardiac rhythm devices.

Scammers are targeting Medicare enrollees and convincing them to sign up for RPN. The scammers steal Medicare numbers and other personal information and bill Medicare for unnecessary RPN services. Those services are often not provided, and even when RPM devices are issued, patients are not monitored even though they are charged monthly for the service. HHS-OIG has advised Medicare enrollees to hang up if they receive a call offering a free brace that will be billed to Medicare and recommends that they check their Explanation of Benefits statements for services that have not been ordered or provided.

If any contact is made and free equipment is offered that requires a Medicare number to be provided, it is likely to be a scam. Any requests for requests for medical equipment should be approved by a trusted healthcare provider, who will evaluate whether the equipment is medically necessary. Medicare beneficiaries have also been advised to refuse to accept deliveries of any unordered medical equipment unless their healthcare provider has ordered it.

A few weeks ago, HHS-OIG sounded the alarm about another Medicare scam involving durable medical equipment (DME). Medicare enrollees are being contacted and offered urinary catheters at no cost by an unscrupulous DME company. “Usually, the DME company will obtain its own authorizing provider, who does not know or have a relationship with the enrollee, to sign an authorization for DME,” explained HHS-OIG. “Occasionally, the DME company may get the enrollee’s provider to sign an authorization for the DME.”

According to the National Association of Accountable Care Organizations (NAACOS), around $2.8 billion is estimated to have been fraudulently billed to Medicare for urinary catheters. Medicare payments for the billing codes used for urinary catheters increased from $153 million in 2021 to $2.1 billion in 2023.

The post HHS-OIG Warns Consumers About Remote Patient Monitoring Scam appeared first on HIPAA Journal.