Linda Hennis was reviewing her Medicare billing statement in January when she noticed something strange: It said that a company she had never heard of had been paid about $12,000 to send her 2,000 urinary catheters.

But he had never needed or received catheters.

Ms. Hennis, a retired nurse who lives in a Chicago suburb, noticed that the company selling the plastic tubes was called Pretty in Pink Boutique and was based in Texas. “There’s a mistake here,” she recalled Ms. Hennis thinking.

She is among more than 450,000 Medicare beneficiaries whose accounts were billed for urinary catheters in 2023, up from about 50,000 in previous years, according to a new report by the National Association of Accountable Care Organizations, an advocacy group that represents hundreds of healthcare organizations. systems throughout the country. The report used a federal database of Medicare claims that is available to researchers.

According to that analysis, the massive increase in catheter billing included $2 billion charged by seven high-volume providers, potentially accounting for nearly a fifth of all Medicare spending on medical supplies in 2023. Doctors, insurance departments state and health care groups around the world The country said the increase in claims for catheters that were never delivered suggested a wide-ranging Medicare scam.

“We think it’s outrageous,” said Clif Gaus, chief executive of the group that conducted the analysis.

Dara Corrigan, who directs the Center for Medicare Program Integrity, declined to say whether the agency was investigating the catheter bills. When the federal government suspects fraud, she said, it sometimes holds payments in escrow while it reviews claims. But he did not say whether that had happened with any of the catheter payments.

“We’re doing all of this behind the scenes to ensure the integrity of the investigation,” Corrigan said, speaking generally about the agency’s process. He described Medicare billing scams as “one of these ever-present, ever-frustrating problems.”

Pretty in Pink Boutique, which billed Medicare at least $267 million for catheters between October 2022 and December 2023, could not be reached by phone.

Medicare billing scams can have far-reaching consequences. Even if patients don’t pay the bills themselves, increased spending by the government insurance program can increase premiums paid by enrollees in the future.

Catheters and other medical supplies are frequent targets of billing schemes. Last April, the federal government brought criminal charges against 18 defendants who had submitted invoices for non-existent coronavirus tests and other services related to the pandemic. And in 2019, the Justice Department said there were broken an international fraud ring involving more than $1 billion in false billing for back and knee braces.

Medical supply companies are easy to establish and have a relatively low bar for demonstrating medical necessity. Companies “don’t need much to prove why grandma needs a urinary catheter,” said Eva Gunasekera, who previously led health care fraud litigation at the Justice Department.

Patients and doctors who have been reporting mysterious catheter claims to Medicare for months say they are frustrated by the government’s lack of communication about whether billions of dollars have been lost due to an ongoing billing scam.

One of the members of the advocacy group, Dr. Bob Rauner, runs a large network of doctors in Nebraska. In an interview, he said his patients had been collectively billed nearly $2 million in 2023 for phantom catheters. (He tracks such expenses because his organization receives bonus payments from Medicare when patients have good health outcomes with low overall medical spending.)

“I only know it’s all fraud because our doctor didn’t order it and our patient never received it,” said Dr. Rauner, who filed a complaint with the federal health department’s Office of Inspector General in mid-December.

The vast majority of suspicious claims identified by the new analysis came from seven companies, many of which have shared executives, according to public documents and the advocacy group’s report. Only one of the companies had a working phone number and did not respond to a request for comment. The other numbers were disconnected, went to different businesses or, in one case, went to a previous owner.

Pretty at Pink Boutique registered with medicare to the address of a house in El Paso. His phone number is for an auto body shop called West Texas Body and Paint, where an employee who responded to a call from a reporter said the shop gets “calls all day, every day” from Medicare members worried about bills. fraudulent.

Pamela Ludwig runs an unrelated business in Nashville also called Pretty in Pink Boutique. She has received so many complaints about catheters that added a page to their website explaining that their business was not part of any scam.

“There are people who call me, insult me ​​and yell,” Ludwig said. “They feel violated.”

She called Medicare to file a complaint in September, she said, but the barrage of phone calls hasn’t stopped. In November, her husband heard from a New York City banker, who told her that several men had come to her office asking to open an account for Pretty in Pink Boutique. “He asked us if we had sold our business recently,” Ms. Ludwig said.

The issue came to the attention of the Oklahoma Department of Insurance in July when it was investigating fraudulent Medicare claims for Covid-19 test kits. Officials also noted a surprisingly high number of claims for catheters.

“When we started asking seniors, they told us they had never used urinary catheters and didn’t know why the claims were there,” said Ray Walker, the department’s director of Medicare assistance. Since then, he estimates that at least 70 Medicare beneficiaries have filed complaints about catheter claims, including one this week.

In Illinois, Travis Trumitch said he reported four cases of possible catheter fraud to the federal health department’s inspector general after his group, the Illinois Senior Medicare Patrol, received more than a dozen calls from Medicare beneficiaries . The group is part of a national network that warns seniors about federal health insurance scams.

It’s unclear how the catheter companies obtained the Medicare accounts of so many people, but Trumitch said some people told him they had previously received phone calls asking for their Medicare identification number. Others said they had not received any calls but suspected their names had been obtained through data breaches.

Suzanne Gustafson, 76, complained to Medicare last month after noticing a suspicious payment of about $4,000 made to a New York company. She also saw a similar charge on her husband’s account. And when she posted on Facebook, wanting to raise awareness, another friend reached out and said she had been charged with a similar charge.

Ms. Gustafson speculated that the company may have obtained its Medicare information from a Data leak at a hospital he had gone to in Louisville, Kentucky. This wasn’t Gustafson’s first encounter with suspicious Medicare bills: Last year, he said, he was falsely billed for coronavirus tests that he never ordered or received.

Ms Hennis said she does not know how her information got to the Pretty in Pink boutique. When she reported the inappropriate billing to Medicare, she said, she was told that someone had created a second Medicare account in her name and billed the catheters to the new account.

“I hate the idea of ​​someone ripping off Medicare,” he said. “Many of us rely on it. “It is simply ethically wrong.”