It becomes a growing problem as more and more people live longer and are on Medicare.
“What that ultimately does is it raises medical costs for everyone. In essence, every single person in this country is a victim of this crime,” says Michael Carroll, US Postal Inspector.
The story begins with Donald and Shirley Blaine - a husband and wife duo who formed a company called Respa-Test.
“They were claiming they were doing these very complicated sleep studies which would require overnight monitoring of oxygen, and heart rates, and things like that by a doctor and a staff,” says Carroll.
“Our investigation showed that the procedures that were actually completed in the office were very simple procedures, low cost procedures that might be billed to Medicare for $3 or $5,” says Carroll.
Postal inspectors say the Blaines would charge Medicare close to $500.00.
“Everyone`s premiums, everyone`s costs, everyone`s insurance costs, medical costs go up as a result of a fraud like this,” says Carroll.
Some advice from postal inspectors: Keep a close eye on your medical and insurance bills.
“If you go to the doctor for a relatively simple procedure and you see something that appears to be much more complicated billed or your explanation of benefits appears to be much higher price than what you think it should have been billed at, then you need to call the insurance company,” says Carroll.
The Blaines eventually pleaded guilty prior to their trial. They were sentenced and ordered to pay $5 million dollars in restitution.
