Seniors say Medicare accounts fraudulently billed for thousands of dollars | Investigation

Our investigative team has been looking into questionable medical billing raised by two viewers. It comes after they received benefit notices from Medicare that raised red flags. Investigative reporter Charedelli has more on what exactly unfolded. Our viewers looked at their Medicare benefit statements and found charges for services and equipment they say their doctors didn't order. The company named on the bill has now been flagged by some health networks, including Medicare. >> It's taxpayer money. It affects all of us all the same. >> Jacob Cohen says he checks his Medicare benefit statements religiously. His most recent one outlined charges for nearly $9,000 for catheters and other supplies build from September 2024 until January of this year. >> Spoke to Medicare uh after I found out and said, "It's definitely not me. I didn't order this supplies." And I believe it's Medicare fraud. >> Never received any of those things, so I knew that was all bogus. >> Jim Denty says he too had the same suspicious activity on his Medicare account. 21 grand build for catheterss and other equipment. He also called the Medicare fraud hotline listed on the notice questioning the improper payments. >> All they would tell me was this company is under investigation. >> Welcome to Sunshine Senior Solutions. The company listed on both bills is Sunshine Senior Solutions of Delray Beach, Florida. A company flagged by UC Health in Colorado for suspicious charges and potential fraud. Florida corporate records show the current owner of record is male Tibidzi. Attempts to reach him were unsuccessful. [music] >> Bringing the heart back to healthcare. But the investigative team dug into Florida corporate records and found Dana Poa was an owner of record when some of Denty and Cohen's questionable billing occurred. Reached by phone, she insists she was not involved in any fraudulent billing and pointed out that late last year she sold the company. POA referred us to an attorney who didn't return multiple calls for comment. She also admitted she was the girlfriend of Victor Vanvickery, who's serving seven years in federal prison on an unrelated Medicare fraud scheme that cost taxpayers millions of dollars. >> It certainly seems like Medicare is going very slow. They said this could be years of investigating this company before they come to any conclusion. >> Tensei says earlier this year, Medicare informed him his account number was compromised and issued him a new one. He's angry that there's not more urgency investigating the waste of taxpayer money. He says even after he reported the first set of questionable charges by Sunshine Senior Solutions, Medicare paid out a second claim. He questions why >> don't you have a red flag system that keeps you that puts up, you know, puts up a red flag and lets them know, hey, we're not processing any more claims from Sunshine Solutions. The Centers for Medicare and Medicaid Services told us that it has barred Sunshine Senior Solutions from the Medicare program in June. In a statement, the agency also says fraud investigations are complex and require extensive factf finding and legal reviews across agencies. Seniors who suspect that they may have been wrongfully build by Sunshine Senior Solutions should reach out to Medicare. And here's some advice. Guard your Medicare number like a credit card. Hang up if you receive unsolicited calls for personal information and always check your statements.