Durable Medical Equipment (DME) refers to medical devices and equipment that can be used repeatedly and are intended for use in the home. Some examples include wheelchairs, oxygen tanks, hospital beds and walkers. Among the many benefits of using DME are improved quality of life, independence and convenience. Durable medical equipment can be used in the comfort of one's own home, reducing the need for frequent trips to healthcare facilities.
In many cases, DME can be a more cost-effective solution than inpatient or long-term care. It is often less expensive to provide care and support at home using DME. As well, the equipment is typically covered by insurance, including Medicare and Medicaid. Of course, this helps to reduce the cost burden on patients.
A federal jury has convicted two Miami doctors for their roles in a Medicare scheme.
As reported by the United States Department of Justice this week, two doctors from right here in Florida were convicted of Medicare fraud. 54 year-old, Dean Zusmer and 45 year-old, Lawrence Alexander are both from Miami. The former was a chiropractor and the later was an orthopedic surgeon. The pair was found guilty of submitting more than $31 million in claims for expensive durable medical equipment.
According to the DoJ, the former doctors made claims for DME that Medicare beneficiaries did not need and that were procured through the payment of kickbacks. Court documents and evidence presented at trial showed that Zusmer conspired with others to steal millions of dollars from Medicare. He owned one of four DME companies that collectively billed Medicare over $31 million for medically unnecessary DME.
Zusmer was paid $15 million for his bogus claims.
One of his co-conspirators was Jeremy Waxman. He acquired patient referrals and signed doctors’ orders by paying kickbacks to marketers who used overseas call centers to solicit patients. He also got telemedicine companies to procure prescriptions for unnecessary braces for these patients.
Alexander owned one of the DME companies with Waxman. They concealed both of their roles in the scheme by putting the DME company in the name of one of Alexander’s family members.
Zusmer and Alexander face heavy prison time.
“Zusmer was convicted of conspiracy to commit health care fraud, health care fraud, conspiracy to pay illegal health care kickbacks, paying illegal health care kickbacks, and false statements relating to health care matters,” reports the DoJ, “He is scheduled to be sentenced on April 20 and faces a maximum penalty of 10 years in prison on each of the following counts: conspiracy to commit health care fraud; health care fraud; and paying illegal health care kickbacks.”
Zusmer also faces a maximum penalty of five years in prison for conspiracy to pay illegal health care kickbacks and false statements relating to health care matters. “Alexander was convicted of false statements relating to health care matters,” the DoJ report concludes, “He is scheduled to be sentenced on April 20 and faces a maximum penalty of five years in prison...Waxman was previously sentenced to over 15 years in prison for his role in the scheme.”
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