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  Fraud and Abuse

email: reimburse@cochlear.org




These pages describe examples of fraud and abuse in securing sales or third-party insurance reimbursement for cochlear implants and related services. They describe conduct that are a matter of public record so that consumers can recognize and avoid being harmed by them. Information provided herein is not proprietary or otherwise confidential and has largely been obtained from cochlear implant users.

Cochlear Americas is the oldest and most dominant manufacturer in the cochlear implant industry. As such, most of the available documentation relates to Cochlear practices. However, this should in no way imply that these practices are limited to Cochlear.



"Fraud" is intentional deception or misrepresentation made by an individual or provider that is known to be false, and that could result in some unauthorized benefit.

"Abuse" describes incidents or practices of providers that are inconsistent with accepted sound medical, business, or fiscal practices. These practices may (directly or indirectly) result in unecessary costs to health plans, improper payment of claims, or payment that fails to meet professionally recognized standards of care or are otherwise not medically necessary.

SOURCE: Medicare Durable Medical Equipment Regional Carrier (DMERC) Region C Supplier Manual (July 1995)