Granny Catches Medicare Fraud

ABC News goes undercover to investigate insurance scams costing billions.
1:36 | 03/01/12

Coming up in the next {{countdown}} {{countdownlbl}}

Coming up next:

{{nextVideo.title}}

{{nextVideo.description}}

Skip to this video now

Now Playing:

{{currentVideo.title}}

More information on this video
Enhanced full screen
Explore related content
Comments
Related Extras
Related Videos
Video Transcript
Transcript for Granny Catches Medicare Fraud
This -- woman you're about to me she's not your typical undercover reporter she's our producers 82 year old grandmother and she took a hidden camera. And headed to the doctor's office and with reports and Medicare fraud in the news what she found might shock you. Our chief investigative correspondent Brian Ross joins us now Brian. Terry we used hidden cameras and an 82 year old undercover grandmother to see firsthand how all that fraud can happen. How a simple trip to the doctor's office can result in a diagnosis for illnesses that don't exist expensive treatments and supplies that are not needed. It's called the town Medicare dollars -- McAllen Texas. People in the medical profession are getting rich here but doctors parking lots are full of luxury -- And investigators say some doctors fly in on private planes spend a day or to -- week here and make millions of dollars a year from Medicare. Getting rich off to you and me we have ten of the top positions. Who have build nearly 200 million dollars in one specialty area last year alone. To see how it works we went undercover -- account with an 82 year old -- -- states accompanied by her granddaughter. ABC news producer Megan -- back. Like any senior citizen are undercover grandma represents a potential windfall for home health care company. If a doctor -- -- the need for home health care and if there's a Medicare number to deal with that number that's the keys to -- -- And they've just continue to do it with impunity. Thus far that's the case. As we saw we rented an apartment in the count and rigged with hidden camera and moved in our grandma and her granddaughter. -- -- hypertension and -- -- -- Doris Day is a healthy woman who played some golf -- -- And -- on the line dancing at the -- -- here in the area but it wasn't long before she found a number of so called recruiters from home healthcare companies. Eager to take advantage of -- Medicare number. -- If the doctor -- as well. Including one recruiter who personally took her to a doctor -- child. -- -- The doctor is the gatekeeper. Without her certification. Medicare won't pay for anything. He -- staff saying. But the files we got later from the doctor's office which -- a patient in supposedly terrible health. On the patient referral form signed by the doctor a certification. That our undercover grandma was home by. On the Medicare home health care forms a description of a patient who needs assistance for all activities unable to safely leave home unassisted. A diagnosis authorities told us that could open the door for a huge fraud involving home health care. It's worth tens of thousands of dollars a month. That's all justified by -- was indeed the very next day. A nurse on the home health care company showed up to treat our undercover grandma for a variety of ailments including diabetes which she does not happen. And over the course of a month. Home health care company and the doctor billed Medicare almost 18100. Dollars on -- want to ask you about. The doctor involved badly need that garage. Declined our request for an energy music did not want to talk about the case -- we caught up with. I don't -- diagnosed with diabetes which. Anything you buy -- make up these diagnosis from. Doctor lawyer later admitted there were errors on the health forms they're very serious allegations man -- someone other than that doctor. He did not say who put in the bogus diagnosed. Which of course leads to the question why didn't the doctor -- if someone was falsified her diagnosis on the docket. Our Medicare system is an honor system. And there's not much -- left in the system see things like this. The inspector general's office told us today it is now open its own investigation. Of what happened in our case. It's part of a broad crackdown has started on dozens of other doctors and health care companies in McAllen. As for the 18100 dollars billed to Medicare for our undercover grandma ABC news will reimburse the government for the full amount paid for treatment that was not me.

This transcript has been automatically generated and may not be 100% accurate.

{"id":15830592,"title":"Granny Catches Medicare Fraud","duration":"1:36","description":"ABC News goes undercover to investigate insurance scams costing billions.","section":"Nightline","mediaType":"Default"}