9 Investigates Medicare Fraud

by: Blair Miller Updated:

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CHARLOTTE, N.C. - Doctors are billing Medicare for dead patients and a Channel 9 investigation uncovered it's happening here, costing taxpayers millions of dollars.

Eyewitness News Anchor Blair Miller went through a government audit and found local businesses accused of billing for dead patients.

He took those findings to a congressman who's now taking action.

Every year, billions of tax dollars are given to Medicare to go toward people who need it and rely on it.

In federal records from last year, Channel 9 found Medicare paid $23 million for patients who are dead; people who were once legitimate recipients of Medicare benefits, but the benefits continued after they died.

A report from the office of inspector general in Washington, D.C. identified 251 providers nationwide with a high number of claims for dead patients.

“Obviously, if they're submitting a large number of claims for deceased people, that's a high indicator of fraud in our minds,” said Office of Inspector General Dwayne Grant.

Eyewitness News filed a freedom of information request to learn who the unnamed providers are, and we found several in North Carolina, three in the Charlotte area.

Channel 9 went to the local providers singled out for billing for dead people.

Advanced Home Care in southwest Charlotte provides medical supplies to patients for a variety of injuries or illnesses.

They didn't even know about the federal report until Eyewitness News shared it with them. 

“Thank you for sharing this with us.  It was a shock to us. You would think the agency would share this with us but now we're looking into it as a result of what you found.  If we have received any money that we should not have, we will pay that back," said Joel Mills, the CEO of the company headquartered in High Point.

Also on the list: Health Care Product Solutions of Fort Mill.  No one there returned Channel 9's calls.

At Livewell Medical, in South Park, said they too weren't aware of the audit.

“There's absolutely no way a doctor doesn't know if his patient is alive or dead,” said David Williams with the Taxpayer Protection Alliance.

Williams said the blame doesn't all fall on the doctors or suppliers.

He said Medicare must do a better job of tracking repeated claims for patients who have died.

 “This isn't a tough question.  Are they living or aren't they living?  If they're still living they should get the benefits, if they're not, shut off the benefits,” Williams said.

In the Channel 9 investigation, Eyewitness News discovered Medicare has no process for investigating providers who file high numbers of claims for the dead.

The policy is simply to reject those claims but not to follow up.

Many in Washington including NC Rep. Robert Pittenger believe that needs to change and as a result of what Channel 9 found, he plans to contact the head of Medicare.

“I think Medicare should play the primary role. They should be the ones who have the obligation to find out who's eligible and who isn't,” Pittenger said.

Pittenger plans to use the Channel 9 investigation information to send letters to Medicare and the U.S. Department of Health and Human Services.

He wants to make sure there's something in place to keep this from happening again.

This issue just adds to the concerns about waste and fraud within Medicare.

Just last week, a Florida senator introduced a bill that he says would put new protections in place to get Medicare fraud under control.

He's calling it an “all-out press combat Medicare fraud.”