Three retired Nashville school employees found more than $26,000 in paid medical-equipment claims for elbow braces and catheters they said they never ordered, needed, or received.
One former teacher discovered six claims totaling more than $16,000.
A retired school social worker found more than $8,000 in catheter claims, while another retiree saw more than $2,000 paid for elbow braces.
The money did not come from the retirees’ bank accounts. The payments appeared on Explanation of Benefits statements from HealthSpring, the Medicare Advantage provider offered to Metro Nashville Public Schools retirees.
One Retiree Found Six Claims From Three Suppliers
Rose Lundberg, who taught in Metro Nashville Public Schools for 14 years, found more than $16,000 in payments for elbow braces she said she never requested or received, according to WSMV4 Investigates. Her HealthSpring Explanation of Benefits listed six claims submitted by three medical-equipment companies.
Retired school social worker Barbara Gay found more than $8,000 paid for catheters she said she did not need or receive. A third former district employee showed WSMV an EOB containing more than $2,000 in payments for elbow braces she also said she never received.
The Claims Used Their Medicare Identities, Not Their Bank Accounts
WSMV reported that medical-equipment companies obtained the retirees’ Medicare beneficiary identification numbers and used them to submit claims for products under their names.
Once the claims were approved, the suppliers received payments even though the retirees said the equipment had never been requested or delivered.
The retirees discovered the activity by comparing the supplier names, equipment descriptions, and payment amounts on their EOBs with the care and products they had actually received.
Metro Schools Found No Evidence Its Systems Were Breached
Several retirees questioned whether someone had accessed information connected to the school district because multiple former employees had found similar claims.
Metro Nashville Public Schools said it found no indication that its systems had been compromised. The district described the disputed billing as part of a wider Medicare fraud problem rather than an issue limited to MNPS retirees.
The district nevertheless terminated its agreement with HealthSpring, citing continuing concerns about how the issue was managed and whether retirees received accurate, timely communication and support. MNPS has begun searching for another Medicare Advantage provider and expects the transition to occur in January 2027.
HealthSpring told WSMV that it works with members, employer groups, health care providers, government agencies, and law enforcement to detect and reduce fraudulent billing.
The Federal Moratorium Does Not Block Every Equipment Claim
The Centers for Medicare and Medicaid Services imposed a six-month nationwide enrollment moratorium on certain durable medical-equipment and medical-supply companies beginning Feb. 27, 2026.
The CMS moratorium applies to initial Medicare enrollment applications and certain changes in majority ownership. It does not automatically remove already enrolled suppliers or prevent every existing company from submitting claims.
CMS said the restriction followed its prevention of more than $1.5 billion in suspected fraudulent billing involving durable medical equipment, prosthetics, orthotics, and supplies during 2025.
Medicare Says to Compare Every Claim With Care Actually Received
Medicare advises beneficiaries to compare the dates, suppliers, services, and equipment shown on each statement with their own appointments and records.
Someone who finds an unfamiliar claim on a Medicare Advantage EOB should contact the plan using the number printed on the insurance card or statement. The supplier name, claim date, equipment description, and payment amount should be kept with a copy of the EOB.
Suspected fraud can also be reported through Medicare’s fraud-reporting page or by calling 1-800-633-4227.