Before a DME supplier may bill Medicare for DME suppliers it provides to a Medicare beneficiary, it must first obtain the beneficiaries authorization for the order. In qui tam lawsuits brought under the civil False Claims Act, whistleblowers and their whistleblower attorneys have alleged that DME Fraud by suppliers which shipped DME supplies to Medicare beneficiaries without first receiving their authorization for the order.

Moreover, whistleblower lawsuits have also alleged that DME suppliers refilled patient’s prescriptions without first obtaining patient authorization for the refill. DME suppliers that supply refill orders, are required to contact the beneficiary for authorization prior to dispensing the refills. In other words, the DME supplier may not automatically ship the refill product on a predetermined basis, even if authorized by the beneficiary. This is done to ensure the refilled item remains reasonable and necessary.  Contact with the beneficiary or designee regarding refills may occur no sooner than 14 calendar days prior to the delivery/shipment date.

Whistleblower lawsuits brought under the federal False Claims Act have alleged that DME suppliers refilled Medicare beneficiaries DME orders without first obtaining their authorization to do so. Because these orders are reimbursed by Medicare, billing Medicare for an unauthorized DME refill violates the federal False Claims Act.

No Fees Without Recovery

Ross M. Wolfe and the Weiser Law Firm litigate whistleblower lawsuits on a contingent fee basis, so whistleblowers do not pay attorneys’ fees or court costs unless there is a recovery.

Please contact Ross M. Wolfe if you would like to speak with a whistleblower attorney for more information about the whistleblower process, billing the federal government for unauthorized DME orders or to schedule a free confidential consultation to discuss your potential case.