Lincare unethical?

[boxofrain]

Hello all, I have a situation and would love to get your advice. Back in July 2020 i started with CPAP and got my machine from Lincare. Since it was during the height of COVID, a guy named Dave brought the machine to my car, gave me some real quick instructions and wished me good luck. Before I left, I asked him if the machine was brand new and he said yes it is.

Fast forward, I immediately turned to this group when I couldn't quite figure out how to use the CPAP and get the best results. Once I installed OSCAR, I read the data from the card in my machine only to see that the machine was used starting in December, 2019.

I see a few issues here. First, I assume they did not disclose to my insurance (Medicare) that they are billing for a used machine. Their bill to Medicare is like $330 per month!!! That in itself is highway robbery but may be legal if the machine were actually new.

Secondly and most important, they lied to me saying my machine was new. Being a brand new user, and knowing it was in the middle of the COVID pandemic, I NEVER would have accepted a used machine. I would have bought a new on online before accepting a used one from Lincare. That should have been MY CHOICE, new vs. used.

So I have the proof here. My question, is this some form of "malpractice" on Lincare's part. I am not a litigious person at all. I don't think I have ever sued anyone in my entire life! But if this is possibly a malpractice and/or Medicare fraud case, I would like to know it and then figure out what my options are. Btw, I have records from my MD that I had many medical issues during the summer/fall. Do I have a case? Thanks in advance.

[Okie bipap]

First of all, the amount of money they "bill" Medicare is never what Medicare pays. To find out what Medicare actually pays, multiply your copay by 5. That will be the amount Medicare actually pays per month. DME suppliers always bill Medicare much more than what they are under contract to charge hoping someone will mess up and actually over pay them. How many nights does it show the machine was used in 2019? My wife's machine had an SD card in it that showed one nights use six months before she got it. When it was brought to the house, it was still sealed in the manufacturer original shipping box. I figured this was just checking the machine prior to leaving the factory. Look at the run hours on your machine. Divide run hours by eight to get the approximate number of nights your machine was used.

I know my current machine was previously assigned to a different patient, but it showed zero run hours when I got it. When my machine failed after six months use, they gave me a refurbished machine. The fact that it is refurbished doesn't bother me.

I am not saying Lincare is unethical. I'm only saying make sure of your facts before you pursue a formal complaint to Medicare.

[chunkyfrog]

OMG!
Who knew?

[bwexler]

You have not been a member here long enough to se the "official" opinion on most Major DMEs like Lincare and Apria to name a couple.

If there lips are moving they are lying.
If it is midnight and a DME tells you it is dark outside, go outside and look for yourself.

I doubt Medicare can keep all the DME complaints in a single room. Maybe an airplane hanger.
Your welcome to file a complaint. but don't hold your breath waiting for a resolution.
OH! Wait a minute. Isn't that why you are here in the first place.
To get a machine that prevents you from holding your breath while you sleep.

[boxofrain]

If there lips are moving they are lying.
If it is midnight and a DME tells you it is dark outside, go outside and look for yourself.

I doubt Medicare can keep all the DME complaints in a single room. Maybe an airplane hanger.
Your welcome to file a complaint. but don't hold your breath waiting for a resolution.
OH! Wait a minute. Isn't that why you are here in the first place.
To get a machine that prevents you from holding your breath while you sleep.

OMG Bwexler... cracked me up! Thanks so much. I needed that!