06/11/2025    Paul Kesselman, DPM

Medicare Fraud Hurts Everyone

Fortunately this was not a DPM, but an almost
octogenarian formulated a $!B DME fraud scheme via
multiple marketing companies who managed along
w/cooperating patients, physicians and other
suppliers to perpetrate one of the largest
takedowns in the history of the CMS Fraud
investigations strike force. If you wonder why the
application process to obtain a DME PTAN or retain
the one you have via revalidation, look no further
than this report $1B Strike Force Bust.

My only question to all involved in this and
previous large takedowns is WHAT TAKES YOU SO LONG
and why are these investigations so expensive!

If any of these people would listen to me they
would put every supplier on a bell curve with an
expected income estimate based on others in their
industry, their years in business and multiple
other factors. As soon as there is an aberration,
someone needs to start looking at the income
streams and start auditing these companies.
It is absolutely inexcusable that these and other
large scale findings are not noted sooner prior to
the money being sent off shore nowhere to be
found.

I myself have been the target of two companies who
allegedly provided me with a Continuous Glucose
Monitor. I have filed complaints with Medicare
and the OIG against these companies.

It is imperative you tell your patients, family
friends as well as yourself that you must check
your EOMB or other third party statements.
Preserving the Medicare Trust Fund is everyone's
business.

In other recent mega million dollar cases, your
PECOS accounts have been compromised and your EFT
accounts changed to allow unscrupulous individuals
to submit fraudulent claims on your behalf with
the money filtered to an account other than your
own.

As I have posted previously, your bank account
where EFT's are sent are also prime targets of
thieves. Be sure those accounts are kept secure
as is your PECOS enrollment username and password.
As with other passwords, don't share them with
anyone but your most trusted and needed employee.
Remember that no one (not even the PECOS employees
who you call for resetting a password) have access
to your password. And be sure you never give to
someone posing as a PECOS employee (they will
never ask for it!). Changing your PECOS access
information as you do with other accounts is
essential!

Keeping this information is sacrosanct and it is
true for the solo provider no matter what the
specialty to organizations with hundreds of
employees.

Paul Kesselman, DPM, Oceanside, NY

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