Mr. Randy Sease is a former Special Agent of the FBI; Deputy US Marshal; and Medicare Fraud Investigator. He is a Certified Fraud Examiner who's primary goal is to defeat the high cost of healthcare. The rules and requirements to be a Participating Medicare Supplier are numerous and expensive. Many rules are archaic and don't achieve the end results that were intended - primarily fighting fraud and abuse - but instead serve to drive up the cost of healthcare while obstructing the ability of a Supplier to help the uninsured. If Congress would cut out some of the archaic and senseless regulation in Medicare (that they have been DUPED by the Insurance Industry into passing) they would greatly reduce the cost of healthcare. I personally know dozens of physicians who've told me they'd cut their fees in half if Medicare would cut their expensive regulatory requirements. As it is healthcare providers must receive larger reimbursements as more and more regulation is piled on. Here's an example of a regulation that mostly disturbs me and one of the reasons I decided to opt out of Medicare and go to the Internet with lower prices. Medicare has a rule that forbids any Provider enrolled in the Medicare Program from charging Medicare more than it charges anybody else. They proclaim that to be gouging Medicare. That makes sense doesn't it? Well, suppose an unemployed, uninsured person with a broken leg enters my store and needs a manual wheelchair. I want to help that person and I give it to him for the price I paid the manufacturer - no profit. Remember that Medicare says the lowest price I sell an item for is the same price I must charge Medicare. That lowest price is now dictated by the Private Insurance Medicare Contractor to be the price I sold it to the uninsured person. The Contractor says that price becomes my "usual and customary" price. They can audit my business and find that I charged that uninsured person only half the Medicare Allowed Fee Schedule Amount. They will then declare that price to be 'usual and customary' and they can retroactively for 4 years make me refund an "Overpayment" to Medicare for the difference between that lowest price and the Fee Schedule Amount multiplied by the total number of manual wheelchairs provided over the previous 4 years. It could be enough money to bankrupt any supplier. That was the warning I received from a Medicare Private Insurance Contractor several years ago. A Medicare Supplier is taking a huge risk by trying to help the poor, unemployed, sick, elderly people who are uninsured. They are realistically 'locked in' to charging everybody the higher fee schedule amount - even the uninsured - simply because of an archaic and poorly administered regulation. I want to HELP EVERYBODY including the uninsured. Your pitching in by filing your own claim helps me help others and it saves you, Medicare and taxpayers a lot of money. While Congress continues to TALK about the high cost of healthcare, YOU and I are ACTUALLY DOING SOMETHING about it. My promise to ALL of YOU is that I will continue to help the disadvantaged, unemployed and uninsured whenever they are in need of home medical equipment and supplies. I ask for your help by considering a purchase from us. Thank You All! |