Why did the con artist start selling durable medical equipment? Because he heard it was a "bracing" business opportunity!
But seriously, the case of Jesse Foote and his role in a massive durable medical equipment (DME) scam is no laughing matter.
A Connecticut man has pleaded guilty to his involvement in a sprawling DME fraud and kickback scheme, costing health care benefit programs, including Medicare and TRICARE, more than $7.8 million. This scam is a sobering reminder of how fraudsters exploit the system, endangering both the financial integrity of healthcare and the well-being of countless beneficiaries.
How It Works:
Between December 2017 and March 2021, Jesse Foote orchestrated a fraudulent operation with telemarketing call centers, DME suppliers, and telemedicine companies. The scam began with overseas telemarketers who targeted Medicare beneficiaries, convincing them to accept unnecessary medical equipment like orthotic braces. These leads, complete with pre-written doctors' orders, were then passed through a network of bribed doctors who signed off on the equipment without even assessing the patients. Foote would sell these fraudulent orders to DME suppliers, who then submitted bogus claims for reimbursement to Medicare, TRICARE, and private insurers.
Who’s Targeted:
The primary victims were Medicare and TRICARE beneficiaries, many of whom were elderly or had limited access to healthcare information. These individuals were duped into believing they needed the equipment, all while their personal information was being used to generate fraudulent claims.
Real-Life Example:
Jesse Foote's scheme is a textbook example of how a seemingly legitimate business can be twisted into a tool for fraud. By exploiting vulnerable patients and corrupting medical professionals, Foote and his associates drained millions from federal healthcare programs, enriching themselves at the expense of those truly in need of care.
Why You Should Care:
Healthcare fraud doesn't just siphon off money from essential programs; it undermines trust in the system. For every fraudulent dollar claimed, there's a ripple effect that could lead to increased scrutiny, higher costs, and more complex regulations for legitimate claims. If you're a beneficiary of Medicare, TRICARE, or any other health insurance, scams like these could impact your access to necessary medical equipment and services.
How to Protect Yourself:
- Verify Medical Equipment Needs: If contacted by a telemarketer offering medical equipment, always verify with your healthcare provider before accepting anything.
- Be Skeptical of Unsolicited Offers: Be cautious if you receive unsolicited calls or messages about medical equipment, especially if they pressure you into accepting something quickly.
- Check with Your Insurer: Before agreeing to any medical services or equipment, confirm with your insurance provider that it is necessary and covered under your plan.
- Monitor Your Insurance Statements: Regularly review your Medicare or TRICARE statements for any unfamiliar charges. Report discrepancies immediately.
- Report Suspicious Activity: If you suspect fraud, report it to the U.S. Department of Health and Human Services Office of Inspector General or the FBI.
Quick Tips & Updates:
- Pro Tip: "Did you know? Doctors are required to evaluate a patient's need before prescribing DME. If you're offered equipment without a proper consultation, it’s a red flag."
- Quick Tip: "Stay alert for unexpected medical deliveries. Receiving equipment you didn’t order could be a sign that your insurance information is being used fraudulently."
Your Turn:
Have you encountered a healthcare scam or heard of one that’s concerning? Share your story with us—your experience could help prevent others from falling victim!
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