Authorities in Texas are investigating how an active 82-year-old grandmother was diagnosed as homebound, with a range of illnesses she did not have, including Type 2 diabetes, opening the door to potentially tens of thousands of dollars in Medicare payments for home health care, supplies and equipment she did not need.
A hidden camera recorded the undercover grandmother's visit to a doctor in McAllen, Texas, where she told the doctor and nurses she exercised regularly and, other than some hypertension and arthritis, was in excellent health. "I've really enjoyed good health all my life, God's been good to me," the doctor was told by Doris Ace,yet the official certification sent to Medicare for home health care services indicate she was homebound and suffered from two internal infections, incontinence and needs "assistance in all activities, unable to safely leave home."
On a patient referral form for home health care service, signed by the doctor, our undercover grandmother was also wrongly diagnosed with type 2 diabetes, even though she was not given a blood test which doctors say is the only way to diagnose diabetes.
McAllen is considered a hot spot of Medicare fraud by the Inspector General's office which has already brought cases against a number of doctors- health care agencies and has many others under investigation. They have ten of the top physicians who have billed nearly $200 million in one specialty last year alone. Nationwide, the Inspector General's office estimates that $60 billion dollars of taxpayer money is lost to unchecked Medicare fraud every year.
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