Dr. Oz: Three Companies Nick Shirley Found Billing Medicare From One Apartment “Almost Certainly Fraud”
Investigative journalist Nick Shirley investigates potentially fraudulent companies billing Medicare for medical equipment in New York, with Administrator for the Centers for Medicare & Medicaid Services (CMS) Dr. Mehmet Oz, who says what they discovered is “almost certainly fraud.”
NICK SHIRLEY: Here, inside these residential apartment complexes, we have some DME companies-durable medical equipment companies-that receive money from New York Medicaid. It’s a bit fishy that they’re operating inside these residential apartment complexes. We’re going to see what’s going on. We have Premier, Lifeline and NextGen. They’re all operating out of one apartment. Let’s see what’s going on. Hello. How’s it going, ma’am? My name is Nick. Is Premier DME here? UNIDENTIFIED WOMAN: Yeah. Yeah, here. NICK SHIRLEY: Three durable medical equipment companies were launched here within just a few months of one another. They take money from Medicaid and Medicare services, so we’re wondering: Where is the equipment? Do you guys not have any of the equipment here? UNIDENTIFIED WOMAN: Actually, I don’t know. No. NICK SHIRLEY: How come your husband has this address registered as the location for three different companies that receive money from Medicaid for durable medical equipment? Do you know what kind of equipment he sells? UNIDENTIFIED WOMAN: I don’t know. He’s coming maybe in half an hour. I don’t know, actually. We don’t have it at home. He has a job. He needs to go to a job. I don’t have any equipment. At home, nothing. No, I don’t have anything. NICK SHIRLEY: Inside this apartment complex, in one apartment alone, there are three DME companies operating out of one apartment. Is that even possible? It says that these places can make about $ 2 million to $ 8 million a year. DR. MEHMET OZ: First off, was there anything in the apartment when you went through it? NICK SHIRLEY: Absolutely nothing. There was a mother and her children, and the husband was out. DR. MEHMET OZ: It’s almost certainly fraud. First off, it’s $ 2 million to $ 8 million a month, believe it or not, when they really get to scale. They may just be at that number now, but these guys grow like vermin very quickly. There are twice as many durable medical suppliers in South Florida as there are McDonald’s because it’s easier to open one than a bank account. The person named on the account is never the person who actually owns the business. In South Florida, the Cuban government is involved. I don’t know where these guys are sending their money, but they’re definitely shipping it somewhere. That’s why I get very nervous about foreign governments getting entangled in this. But to open three in one apartment makes no sense, especially when there’s no product there. All you’re doing is gaming the system. The fact that we didn’t audit it, didn’t catch it, didn’t stop it, and that they’re probably out there making money infuriates me. It should bother folks out there because it’s your tax dollars paying for this. NICK SHIRLEY: So it’s literally impossible for somebody to be operating a durable medical equipment company inside an apartment? DR. MEHMET OZ: Inside an apartment with no goods and two other durable medical equipment suppliers? That’s a major red flag.
