Insurance Fraud? Airsense 10 and ROTECH.

I have changed Advantage plans. Each time I have changed, I have to return my old machine and the new provider sends a new machine (kind of wasteful to begin with). This time a company called ROTECH is involved. They sent me documents to sign and return in order to process the Doctors Rx. I am scheduled for an Airsense 10 (same as I use currently).
The problem is that they want me to sign that if anything happens to this equipment I will owe them $2000. I do not need heated air, only humidifier. It looks like the HIGHEST retail value is about 1,000, but prices range from 500 to 900. I have explained to ROTECH that I will not sign a value over retail at all as that would be FRAUDULENT valuation of a DME product.

As I will not sign, ROTECH is not answering calls or calling back. I feel that this is actually medicare fraud or in FL possibly Fraud against those over 65.

Anyone care to comment and or tell me how to proceed from this point? I nee d my old unit returned to its provider and the new unit issued.

Thanks

Either get a lawyer or sign under duress, or both? Looks like you're over a barrel. What was the agreement for the previous machine? Are you paying something out of pocket otherwise? These machines don't often have problems... do they have you on auto-pay? Just crazy that they require a new machine, I guess because they own it, and they don't want another company's machine. Do these come with zero hours? So many questions.

How long had you had each of the devices? After 13 months you should have owned them and not had to return them.

All my med programs have been advantage plans. The first machine about 2 years, but I was told that was lease only, never to become personal equipment. The second is now 10 months or so but I changed plans. I still have that machine. It has been 3 months since I changed plans and am just now getting ROTECH to issue the replacement. They have a waiting list for DME. I got to the top of list and then they wanted me to sign this document in order to process the issuing of the DME. It values the equipment at 2000 and makes me responsible for it. It looks like that 2000 is between 200 and 400% of actual value.

Seems like this is not acceptable to me. The signature is digital..therefore no place to sign under duress. I thought about this.

Has anyone ever had to sign something like this for their CPAP machine? This just seems wrong as both other machines were delivered with a signature that I received them.

It is obvious your advantage plan wants you to buy out of pocket.
I suggest CPAP.com, the sponsors of this free forum.
Your old supplier will want the old machine back.
Once you have YOUR machine, you can kiss those crooks good-bye.
A lot cheaper than a lawyer.

Bentley'sDad wrote: ↑

Fri May 03, 2024 9:00 am

... I was told ...

Well IMO you gotta get a pencil and paper and call your advantage plan advocate, Medicare and Rotech and get complete explanations and record names. Get out your explanation of benefits and find out specifically what's written there.

Without facts only worthless WAGs can be offered.

Advantage plans have the option of charging perpetual rental, you never own the machine. Here, for example, is how this is explained in the Kaiser Sr. Advantage Plan Evidence of coverage:

In Original Medicare, people who rent certain types of DME own the equipment after paying copayments for the item for 13 months. As a member of our plan, however, you will not acquire ownership of rented DME items no matter how many copayments you make for the item while a member of our plan, even if you made up to 12 consecutive payments for the DME item under Original Medicare before you joined our plan.

But I agree with you that trying to charge you more than the item is worth if anything happens to the equipment sounds fraudulent. It might be legal as liquidated damages for all the rent they won't receive on that unit and having to replace it, but I doubt it. I agree with others that you should contact your SHIP (number is on the back of your "Medicare and You" booklet) or Medicare itself. You might also bring this to the attention of your congressional representative or senator.

I got mine for $399 from our hosts at cpap.com during a Black Friday Sale. I'm going on Medicare this year, but I'm so happy I don't have to play stupid DME games when I do.

You know, I am thinking about this. If the Supplier is having me sign a contract with them, then my Advantage plan DOES NOT HAVE A BINDING CONTRACT. This also means that the parties have to negotiate as they can not make me sign a boiler plate, because that boiler plate must have been negotiated by my plan. My plan only has one local provider......

When I told my plan about all this they said that I pretty much have to sign whatever the provider asks for.

I think that there is a basis for legal action in this. Possibly a Class action....or RICO? Have to think about this some more. If this is nationwide and is a form of fraud I could actually get a 20% fee.

How was the wording in the contract? Was it generic that could apply to any CPAP they rented out or specific for the machine you were going to get? If generically worded, was it stated in such a way that may owe "up to $2000" if the equipment was damaged which could suggest that a lesser dollar amount might be owed for a lesser valued CPAP?
My own DME required a credit card on file for reasons of supplies that may not be covered by insurance and/or if the CPAP incurred damage while in my possession. This is an excerpt from their contract (I removed my actual DME's name). No dollar amount given.

"(e) Customer understands that he or she is liable for any intentional improper use or damaging of equipment beyond normal
wear and tear. This includes, but is not limited to: cabinet damage, liquid damage, and/or smoke contamination. Upon retrieval
by [DME], the condition of all equipment will be analyzed, and if [DME] determines that Customer has
caused any damage to any equipment, [DME} will charge Customer’s credit card on file, without any further notice
to Customer, for all costs associated with repairing and/or replacing such equipment."

I have one friend using CPAP that uses a different DME than myself and their contract was similar and seems to be common for most rental contracts to include a damage clause. If you have the contracts from your previous CPAP's, look to see if there is a clause in it for damage in the 'fine print'.

If your Advantage plan is one where the CPAP is a perpetual rental (not 13 months and you own it) and there is a copay for the rental and supplies, perhaps purchasing a CPAP outright from an online DME may make sense.

Bentley'sDad wrote: ↑

Fri May 03, 2024 6:48 am

I nee d my old unit returned to its provider and the new unit issued.

Ask how much for that unit, just for giggles. Or buy from cpap.com

Bentley'sDad wrote: ↑

Sat May 04, 2024 11:09 am

When I told my plan about all this they said that I pretty much have to sign whatever the provider asks for.

And you call this an Advantage?

Bentley'sDad wrote: ↑

Sat May 04, 2024 11:09 am

You know, I am thinking about this.

I think I would NOT sign with another Advantage Plan. How is this saving money? When you have perpetual rental - such a deal.

Live n' Learn or NOT or just get another *Advantage*.

SleepGeek wrote: ↑

Sat May 04, 2024 3:53 pm

And you call this an Advantage? I think I would NOT sign with another Advantage Plan. How is this saving money? When you have perpetual rental - such a deal.
Live n' Learn or NOT or just get another *Advantage*.

1....Not all Advantage plans do this (though I admit more and more are going to perpetual rental) but they don't all do it.
People need to do a bit of homework when they are changing insurance no matter what insurance a person uses.

2...As to the "how is this saving money" question....you know if you do the math you might see how it saves money.
For me to get a traditional supplemental plan to my Medicare it would cost me well north of 300 bucks a month because I got Medicare prior to age 65. My Advantage plan costs me zero dollars a month. I can buy several machines (or pay a lot of monthly co pays) for that over 3600 dollars a year I would for sure have to pay if I got a traditional supplement.


To the OP: I wouldn't sign anything either and if my wallet allowed it I would just buy a machine myself and tell RoTech to go screw themselves.
To my mind....Perpetual rental means I don't/won't ever own the machine and if I don't own it then why should I be responsible for it crapping out and RoTech blaming me for damage when it was maybe the damn motor crapping out.

Pugsy wrote: ↑

Sat May 04, 2024 4:56 pm

you know if you do the math you might see how it saves money.

Could you possibly give the OP an example of how he is saving money?

Pugsy wrote: ↑

Sat May 04, 2024 4:56 pm

my Medicare it would cost me well north of 300 bucks a month because I got Medicare prior to age 65.

Do the math on that for me.
How does this matter to the OP?

fwiw - I was on Medicare before 55 and later did dabble in a few Advantage plans which is how I found out they are no Advantage esp. when I could no longer use meds I had been using for years. But I have no recall of having to give up my BiPap when changing plans.

I did refuse to give a credit card to Apria when they wanted one.

SleepGeek wrote: ↑

Sat May 04, 2024 6:09 pm

Could you possibly give the OP an example of how he is saving money?

I gave an example of how I could/did save money. Did you not understand the math?
OP is a big boy and needs to do his own math.
I have yet to have my insurance buy me a machine. 15 years on cpap. I do the math.

Have a nice day.

Pugsy wrote: ↑

Sat May 04, 2024 6:56 pm

SleepGeek wrote: ↑

Sat May 04, 2024 6:09 pm

Could you possibly give the OP an example of how he is saving money?

I gave an example of how I could/did save money. Did you not understand the math?
OP is a big boy and needs to do his own math.

Math was your idea.

What you pay 2024:
$174.70 each month (or higher depending on your income). The amount can change each year. You’ll pay the premium each month, even if you don’t get any Part B-covered services.
Who pays a higher premium because of income?
How do I pay my Part B premiums?

https://www.medicare.gov/basics/get-sta ... icare-cost