WASHINGTON — After walking unassisted from the back of a Los Angeles courtroom, 85-year-old Euralda Clodomar refused the hand of a deputy and climbed into the witness chair.
Let the record show, the prosecutor told jurors, that she didn’t use a wheelchair.
Clodomar doesn’t own a wheelchair, let alone the motorized model that was charged to Medicare at a cost of $3,840.
An equipment supplier obtained her Medicare identification number and took her and the taxpayers for a ride in a fast-growing new swindle that has cost the government’s main health care assistance program tens of millions of dollars.
Fifty separate investigations under way in nearly two dozen states have identified $167 million in fraudulent power wheelchair claims, officials said. The Pacific Northwest states involved are Oregon and Idaho.
"It certainly is the fastest growing scam in Medicare," said Dara Corrigan, acting inspector general in the Department of Health and Human Services. "It’s about a wheelchair that is very expensive and about people trying to make a profit."
The medical equipment industry has aggressively marketed its electric wheelchairs, particularly in television ads targeting senior citizens. The number of Medicare beneficiaries with at least one claim for a motorized wheelchair rose from about 55,000 in 1999 to 168,245 in the first nine months of this year.
Part of the increase was due to improvements that allow the wheelchairs to turn in a small radius. But an industry group, the Power Mobility Coalition, agrees that some claims result from fraud, and it is supporting the current government crackdown, called Operation Wheeler Dealer.
"If there is fraud, that hurts the good guys because it puts a black eye on everyone," said Steve Azia, a lawyer for the coalition.
Medicare’s crackdown has recovered $52.5 million so far. Also, new suppliers have been banned temporarily from enrolling in the program, prosecutors have been ordered to bring cases quickly and officials are poised to stop payments. Medical personnel must certify that they have personally seen a patient before prescribing a motorized wheelchair.
Investigators say the cases can include:
By law, Medicare can pay 80 percent of the cost of motorized wheelchairs, and the rest is often covered by insurance companies. Some suppliers, investigators said, have charged Medicare for power wheelchairs costing $5,000 or more while providing much cheaper motorized scooters.
Clodomar and other beneficiaries who testified in the Los Angeles case helped persuade a jury to convict Goodwill Sunday Edukere after just 30 minutes of deliberations. Edukere had to return $249,000 and was sentenced to 33 months in prison.
Clodomar didn’t know a claim had been submitted until federal agents came to see if she had a power wheelchair. She convinced them the same way she convinced jurors.
"I walked from the back of the house, where my room is, to the front," she said in an interview. "I said, ‘I don’t need one, thank God.’ "
Medicare’s 80 percent share for power wheelchairs grew from $22.3 million in 1995 to $663.1 million in 2002. That total already has been surpassed in the first nine months of 2003.
Corrigan said fraudulent operators often try to scare seniors.
"They’ll say to the beneficiary, ‘You may not need it now, but you know how Medicare is going. Medicare might be out of money in a few years,’ " she said.
Copyright ©2003 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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