At a recent congressional briefing, the Centers for Medicare & Medicaid Services (CMS), sharply criticized the Durable Medical Equipment industry, decrying that rampant fraud costs the Medicare system millions of dollars each year. While Medicare fraud certainly must be stopped, the context in which CMS discusses it and the root causes of the fraud need to be addressed.

For years now, CMS has repeatedly pointed the finger at “the industry,” particularly when discussing fraud related to power wheelchairs and scooters.

Let’s take a closer look. The power mobility industry is comprised of the manufacturers of power mobility equipment and the suppliers, businesses ranging from mom and pop operations to large companies. These suppliers navigate CMS’ ever-changing regulations and policies to deliver power wheelchairs and scooters to Medicare beneficiaries living with disabilities. The fraudulent operators are NOT part of the legitimate power mobility industry. They list their addresses as vacant buildings or storefronts, and move from place to place. They are not real businesses; they are crooks.

Consider this: When scam artists bilk investors in land scams, are they referred to as part of the legitimate real estate industry? No. If a car thief steals automobiles, strips the vehicles and is caught reselling the auto parts, is he referred to as part of the auto parts industry? Again the answer is a resounding, no. It shouldn’t be any different in the durable medical equipment business.

Unfortunately, by talking about fraudulent dealers as if they were part of the power mobility industry, CMS has cast a shadow of doubt on dedicated and hard working suppliers. It has unfairly caused the industry to lose valuable credibility with our regulators, Congress and even Medicare beneficiaries. The industry shares with CMS a strong desire to stop Medicare fraud, and we are encouraged that the agency has made fighting fraud a top priority. But every one would be better served if CMS didn’t refer to the scam artists as part of the legitimate power mobility industry.

It is equally frustrating that the industry receives the blunt of the criticism for the fraud when it has been lax supervision of the Medicare system that has resulted in the wasting of taxpayer dollars. It certainly seems hypocritical that the industry gets the blame when CMS allowed the Medicare scams to flourish. How do fraudulent dealers operate in the first place? They receive supplier numbers from CMS that allow them to bill the Medicare system for equipment that doesn’t get delivered to beneficiaries. Clearly, the key to stopping fraud is a system that better scrutinizes which companies receive supplier numbers to bill the Medicare system. The responsibility for doing so falls on CMS.

I’ll have Part 2 next time.