Posted and filed under FWA, Healthcare.

If you working in the “weeds” of healthcare fraud, waste and abuse, you have hopefully come across the newest scheme being perpetuated by our favorite sector of fraudulent specialties; podiatrists.  As with all specialties, there are unique niches of FWA that can be engaged in, that other specialties typically do not have the ability to do, because of nuanced codes, procedures and the like. When we speak to our retired OIG Agents about their histories investigating fraud schemes, they will constantly tell us that most of the unscrupulous providers do not “reinvent the wheel,” they just come up with a new way of using it.

We recently saw this with the flood of telemedicine and telehealth cases that involved DME, as they mirrored the same pattern for the compounds.  We are now seeing that similar pattern with podiatrists and foot baths.  Yes, you read that correctly, a bowl of warm water, your feet and thousands of dollars in fraud.  One of our resources investigated A LOT of podiatry fraud cases, including one that involved about 20 providers that included a 3 month long trial, drug diversion, services not rendered, and nearly every other potential fraud you can conjure up.  Even the fraud currently going on is a head shaker.

The foot baths involve the introduction of some very expensive medications; most, if not all of them, entirely useless in the context by which they are being used.  Of course, this is all done by mail order, and the typical triad exists: patient in one state, pharmacy in another, and podiatrist in yet a third.  The medications in use are questionable, and in at least some regard, are not even able to be used in a foot bath setting (such as a non-water soluble medium).  The numbers are slowly starting to tick up on the money being paid.  It is not just Medicare, but commercial payers are starting to see the issues. 

We always love the fact that our retired OIG Agents are still very active in the FWA space, and can gain this valuable insight into the schemes, and more importantly, provide that very specific expertise in investigative process, audit matters and process improvements.  So the next time you get a nice relaxing pedicure, know someone is using their insurance for not much more, but for a whole lot more.