Medicare Fraud Scheme Targets Urinary Catheters, Estimated Losses Reach $2 Billion

An extensive Medicare fraud involving urinary catheters has been uncovered, with losses potentially amounting to $2 billion.

Over 450,000 Medicare beneficiaries were billed for urinary catheters they never ordered or received in 2023, a significant increase from about 50,000 in previous years.
Seven high-volume suppliers are implicated in the scam, with one company, Pretty in Pink Boutique, billing Medicare at least $267 million between October 2022 and December 2023.
The FBI and Medicare's Center for Program Integrity are investigating the fraudulent billing, which may involve several companies across multiple states.
The scam exploited the low scrutiny of urinary catheter orders, allowing for massive profits despite the low reimbursement rates for each catheter.
Healthcare providers and advocacy groups express frustration over the slow response to the fraudulent activities, which could impact Medicare's financial health and beneficiaries' premiums.