Read more about this issue in The New York Times and The Washington Post. Both these articles help to explain the problem. The Washington Post explains “….an alleged fraud scheme whose scale has little precedent in the history of Medicare, experts said: an estimated $2 billion.”
Additionally, Nashville NPR affiliate 1A spoke with Dan Diamond from The Washington Post to explore in depth “how Medicare missed all the warning signs” about the potential for fraud with urinary catheters.
We Are in Touch with Medicare
We have received dozens of calls from people who received fraudulent claims made by Pretty In Pink Boutique, Inc. WHILE WE SHARE THE SAME NAME, THIS COMPANY IS COMPLETELY UNAFFILIATED WITH US. There are at least FIVE companies registered with Medicare that operate with the name Pretty In Pink Boutique.
We have reported the calls we are receiving to Medicare, and we have been working with callers to try to figure out exactly who is filing these claims so that we can communicate anything we know to Medicare. FRAUDULENT CLAIMS ARE BAD FOR ALL OF US, AND WE ARE ON YOUR SIDE.
WE ARE NOT EVEN SET UP TO BILL CATHETERS (which is the most common item we’ve seen on these claims), and the claims we’ve been able to review contain an entirely different Medicare Identification Number (NPI) from ours. You’ll also notice our website doesn’t mention anything about catheters. We only bill for mastectomy supplies and compression garments.
Our NPI Number is 1831116631 and appears in the Medicare database as Some Other Company, Inc DBA Pretty In Pink Boutique. YOU WILL NOTE A DIFFERENT NPI NUMBER ON THE EOB YOU RECEIVED.
How To Report Fraudulent Claims
The most important thing you can do to make sure the provider responsible for these fraudulent claims is stopped quickly and hopefully brought to justice is call Medicare, your Medicare Alternative, or whatever Secondary insurance provider sent you the EOB (Explanation of Benefits) you received in the mail. PLEASE CALL YOUR INSURANCE PROVIDER IMMEDIATELY.
That insurance company will be able to trace the claim back to the originating provider, WHICH IS NOT US.
You should also report the fraud to Medicare HERE. Click on the orange button on the right that reads ‘FIND HELP IN YOUR STATE”, select your state to connect with your local SMP.
We will fully cooperate with you to assist in identifying the responsible party. Your EOB was generated by your insurance provider as the result of a claim being filed. That will all trace back to the responsible party. WE DID NOT FILE THE CLAIM.
Please Don’t Jump to Conclusions About Us
We are a nearly 20-year-old, family-owned business that prides itself on integrity and doing things the right way. Our staff has received many unfounded accusations and even threats from people jumping to conclusions after a cursory web search, on the assumption that there is only one Pretty In Pink Boutique, which is false.
If you act hastily without more information, you can damage a small business that employs 16 people and has helped over 28,000 people with breast cancer, lymphedema, and other critical medical conditions that need our help.
IF YOU CALL YOUR INSURANCE PROVIDER, THEY WILL CONFIRM EVERYTHING WE ARE SAYING.