When news broke recently of an Alpena nurse facing federal charges for her alleged part in a scheme to defraud Medicare, a Lachine couple realized they were probably victims in a similar scam.

The box of medical supplies that showed up on their doorstep in April, allegedly ordered by a doctor, could have made her husband’s health problems worse, said Jean Skiera.

Medicare and a supplemental insurance company paid the cost of the medical braces enclosed in the box, but the couple could have paid, as well, with injuries from using the devices without a doctor’s orders or with increased insurance costs, Skiera said.

On a fixed income, the couple can’t afford either result, she said.

News Photo by Julie Riddle Ron Skiera overlooks his backyard garden where a back brace sent to him, possibly as part of a Medicare scheme, could have caused him injury as he tended plants.

The scam has taught her to be wary of phone calls.

“Somebody is still doing it,” said Skiera, who regularly gets calls about unwanted health products, even with her number on a do-not-call list. “And I’ll say, ‘You’re full of sh**, and hang up.”

FEDERAL CHARGES

Skiera didn’t suspect she was part of a large-scale Medicare scam until The Alpena News reported that Alpena nurse Fawn Monro had been accused of scheming to cheat Medicare.

Munro was one of 36 people and organizations charged by the U.S. Department of Justice last month in a nationwide, coordinated law enforcement action to combat telemedicine fraud.

News Photo by Julie Riddle Ron Skiera measures one of 1,400 onions he plants in a backyard garden where a back brace sent to him, possibly as part of a Medicare scheme, could have caused him injury as he tended plants.

The federal charge alleges that in 2018 and 2019, Munro, working for a telemedicine company, ordered unnecessary braces without examining patients and caused Medicare to pay more than $1.8 million on false and fraudulent claims.

If Munro does not accept a plea agreement by Jan. 3, she is scheduled to go to trial on Jan. 24 in the U.S. District Court for the Eastern District of Michigan.

Munro’s attorney did not reply to a request for comment for this story.

DOCTORS’ ORDERS

Skiera does not know who called her this spring to say medical equipment was on its way.

News Photo by Julie Riddle Ron Skiera, left, and Jean Skiera, of Lachine, display a box of medical supplies they believe was sent to them as part of a Medicare fraud scheme.

The caller said a doctor had ordered the supplies but didn’t supply the doctor’s name, Skiera said.

Her husband’s doctor would never order equipment for his patients without telling them how to use it, Skiera believes.

Paperwork from Medicare lists a different doctor — an internal medicine specialist in Massachusetts — as ordering the supplies for Ron Skiera.

The back brace, two knee braces, and a pair of knee suspension sleeves the couple found in the box didn’t make sense, either. Ron Skiera’s doctor knew his patient had had multiple surgeries incompatible with the braces, Jean Skiera said.

Following the rudimentary instructions included in the box, Ron Skiera tried using the back brace but thought it could cause him injury while he worked in his extensive garden.

He tried putting a knee brace on but knew instantly it would never work on his leg, he said.

Jean Skiera said she called a number she found with the supplies and asked if her husband’s doctor really said he needed the braces. The woman who answered assured her that that was the case.

“And I says, ‘Well, if he ordered it, I guess there’s not much I can do, you know?'” Jean Skiera said.

NOT FREE

Paperwork mailed separately from the box showed Medicare had paid $2,300 for the supplies. Ron Skiera’s supplemental insurance company paid the remaining nearly $600.

Though someone else paid for the equipment, the couple worries such scams will still bite them in the wallet if it means higher supplemental insurance costs as their company compensates for their losses.

The box of useless medical supplies in her bedroom makes Jean Skiera mad, too.

“Someone who needs it could be using that,” she said, unsure what to do with the braces.

According to the U.S. Office of Inspector General, a beneficiary who receives unwanted or unneeded braces billed to Medicare may later be denied coverage for braces for legitimate medical needs.

FRAUD AND YACHTS

Packing materials in the Skieras’ box list Horizon Medical Associates, of Massachusetts, as the equipment supplier.

A phone number provided as the company’s contact number for complaints or concerns has been disconnected. Another phone number for Horizon Medical Associates leads to an automated answering service.

Federal investigations in recent years have uncovered billions of dollars in Medicare fraud related to unnecessary medical equipment.

Equipment scams often involve a conspiracy between fake medical equipment companies, telemedicine call centers, and physicians to create fraudulent doctors’ orders — often containing names and personal health information of Medicare beneficiaries — requesting medically unnecessary equipment.

In July, the Department of Justice charged Munro alongside medical equipment companies, company executives, and other medical professionals with taking advantage of elderly or disabled patients in schemes involving more than $1.2 billion in fraud, the Department of Justice said.

Two other Michigan residents, from Dearborn and Garden, were also charged.

Some of those charged used proceeds from the scam to purchase exotic automobiles, yachts and luxury real estate, according to the Justice Department.

Julie Riddle can be reached at 989-358-5693, jriddle@thealpenanews.com or on Twitter @jriddleX.

Avoid medical equipment Medicare fraud scams

The U.S. Department of Health and Human Services Office of Inspector General offers the following advice for those wishing to avoid being used to defraud Medicare as part of nationwide medical equipment schemes.

∫ If you receive a call from someone offering a free brace that will be billed to Medicare, hang up immediately.

∫ If medical equipment is delivered to you, don’t accept it unless it was ordered by your physician. Refuse the delivery or return it to the sender. Keep a record of the sender’s name and the date you returned the items.

∫ Be suspicious of anyone who offers you free medical equipment and then requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes.

∫ A physician that you know and trust should approve any requests for equipment to address your medical needs.

∫ Medicare beneficiaries should be cautious of unsolicited requests for their Medicare numbers. If anyone other than your physician’s office requests your Medicare information, do not provide it.

∫ If you suspect Medicare fraud, visit TIPS.HHS.GOV or call the Office of Inspector General Hotline at 800-447-8477.

Source: U.S. Department of Health and Human Services Office of Inspector General

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