Staggering rise in catheter bills suggests Medicare scam

Linda Hennis was checking her Medicare statement in January when she noticed something strange: It said a company she had never heard of had been paid about 12,000 $ for sending her 2,000 urinary catheters.

But she never needed or received catheters.

Mrs. Hennis, a retired nurse who lives in a Chicago suburb, noticed that the company selling the plastic tubes was called Pretty in Pink Boutique and that it was based in Texas. "There's a mistake here," Ms. Hennis remembers thinking.

She is one of more than 450,000 Medicare beneficiaries whose accounts were billed for urinary catheters in 2023, compared to about 50,000 in previous years, according to a new report produced by the National Association of Accountable Care Organizations, an advocacy group that represents hundreds of health systems across the country. The report used a federal Medicare claims database available to researchers.

Massive hike in catheter billings included $2 billion billed by seven providers high-volume, according to this analysis, potentially accounting for nearly a fifth of all Medicare spending on medical supplies in 2023. Doctors, public insurance services and health care groups across the country have said that rising claims for catheters that were never delivered suggested a large-scale Medicare scam. .

“We think it’s outrageous,” said Clif Gaus, executive director of the group that conducted the analysis.

The spending of Health insurance catheters skyrocketed in 2023. [embedded content]

Note: Data is quarterly.

Source: Institute for Accountable Care Medicare claims analysis

By The New York Times

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