Medicare Fraud? You tell me.

In 2006 I was diagnosed with severe sleep apnea and received a prescription for an oxygen concentrator. Like a good patient I contacted Pacific Pulmonary, one of several companies providing medical devices.

They delivered a Respironics EverFlo-Q Oxygen Concentrator and a supply of Salter Labs Nasal Cannulas. For use of this equipment, Pacific Pulmonary has billed Humana, my insurer, about $121 per month, and they have billed me a co-pay of $24 a month. It has been a total of about 60 months, but Pacific Pulmonary claims there were 15 months during which they did not bill.

I am not very good at remembering due dates or payment details, so I leave that to my wife of forty years. She is generally quite frugal, extremely good at meeting all obligation dates and amounts and is good at arithmetic. Perhaps Pacific Pulmonary has billed us only 45 months... I'll take their word for it pending further checking.

In any event, 45 months at about $145 a month, totals over $6,700. During this period, they have sent perhaps an additional 50 nasal cannulas.

Humana has advised that they will no longer pay for Pacific Pulmonary services, and has advised we contact a different provider. This prompted me to add up what we have paid Pacific and what they have provided.

I Googled "Respironic oxygen concentrator" and was instantly provided with the URL of several providers. I clicked on one, http://www.portablenebs.com and learned that the Respironics unit I am using is available for purchase for $599; nasal cannulas are about $12.50 for 10.

To summarize, Pacific Pulmonary has "rented" me a piece of gear worth $600 and tossed in about $75 worth of accessories, for the amazing low price of just $6,700!

Gee, what a business!

Is it legal? Probably. I signed whatever paperwork was presented me.

Is it fraud? In my opinion, decidedly yes! How about you?