In brief: Feds convict CEO, Australia sues Philips, CMS awards new RAC

WASHINGTON – Federal authorities have convicted Gary Cox, 79, CEO of Power Mobility Doctor Rx (DMERx), for orchestrating a $1 billion Medicare fraud scheme involving false doctor orders for medically unnecessary equipment like braces and treatments. Cox and his co-conspirators misled seniors into providing personal information through deceptive advertising and offshore call centers, then used DMERx—a digital platform—to create fraudulent prescriptions. These orders were exchanged for illegal kickbacks from pharmacies, DME suppliers and telemedicine providers. The fraudulent prescriptions falsely claimed doctors had examined patients, when in reality, physicians were paid to approve orders without proper evaluation. Cox and his team hid the scheme using sham contracts and doctored language to avoid scrutiny. Medicare and other insurers paid more than $360 million based on these fraudulent claims. “The defendant orchestrated a scheme to defraud government health care benefit programs on a massive scale, creating fraudulent doctors’ orders used to bill insurers over $1 billion,” said Matthew R. Galeotti, head of the Justice Department’s Criminal Division. “Americans are all too familiar with junk mail and spam calls that target seniors to steal their personal information and promote waste, fraud, and abuse in our economy.” Cox was convicted on multiple charges, including conspiracy to commit health care fraud, wire fraud, and receiving kickbacks. He faces up to 20 years in prison for the most serious charge, with sentencing scheduled at a later date. 

Australia’s regulatory authority sues Philips over CPAP devices 

CANBERRA, Australia – The Therapeutic Goods Administration (TGA), Australia's regulatory authority for therapeutic goods, has commenced proceedings in the Federal Court of Australia against Philips Electronics Australia Limited (PEAL) for the alleged unlawful supply of medical devices that did not meet Australian safety and performance requirements. These included devices used by people at home who suffer from sleep apnea and devices used by patients who need help breathing. The devices, which were recalled in 2021, contained a polyester-based polyurethane (PE-PUR) foam used for noise suppression that had a real risk of degrading, allowing particulates to be inhaled or ingested by the patient, TGA says. Potential harm from short and intermediate exposure included skin, eye and respiratory tract irritation, inflammatory response, headache, asthma, effects on the user’s reproductive system and neoplasia, it says. Potential harm from long-term exposure included cytotoxic, genotoxic and carcinogenic effects, it says. TGA alleges that, due to the risk of the PE-PUR foam degrading, the devices supplied from June 2, 2019, to Oct. 13, 2022, were unsafe, did not perform as intended and were therefore unlawfully supplied. TGA alleges that there were more than 44,000 separate instances of unlawful supply of devices in that period. 

MobilityWorks recognized by Newsweek 

RICHFIELD, Ohio – MobilityWorks, a provider of wheelchair accessible vehicles, mobility equipment and services, has been recognized by Newsweek and Plant-A Insights Group as one of America's Greatest Workplaces for 2025. This marks the second time the company has earned this distinction, having previously been honored in 2023. Published annually, Newsweek's America's Greatest Workplaces list highlights companies across a range of industries that are setting a high standard for workplace culture and employee satisfaction. "Our team members are the heartbeat of this organization, and their commitment to our mission is what makes honors like this possible," said Bryan Everett, CEO. "This award is a direct reflection of the pride they take in serving our clients and supporting one another." With nearly 100 locations nationwide, MobilityWorks continues to invest in team member development and work-life balance. The company also fosters a values-driven culture anchored by its "LOVE IT" core values - Listen, Ownership, Value, Engagement, Integrity and Teamwork. The Newsweek ranking is based on a comprehensive assessment involving employee interviews, company reviews, publicly accessible data and an analysis of over 120 key performance indicators. 

• Related: MobilityWorks entered four new states in 2024, a “pretty ambitious” move that was instrumental in the company hitting 100 locations this year, says CEO Bryan Everett.   

Philips to repurchase shares 

AMSTERDAM – Royal Philips will repurchase up to 6 million shares to cover certain of its obligations arising from its long-term incentive plans. At the current share price, the shares represent an amount of up to approximately EUR 125 million. The repurchases will be executed through one or more individual forward transactions to be entered into in the course of the second and third quarter of 2025, in accordance with the Market Abuse Regulation and within the limits of the authorization granted by the company’s general meeting of shareholders on May 8, 2025. Philips expects to take delivery of the shares in 2027.  

• Related: Philips reported group sales of EUR 4.1 billion for the first quarter of 2025, a 2% decline. 

CMS awards RAC contracts to Cotiviti 

WASHINGTON – CMS in April named Cotiviti GOV Services the new Recovery Audit Contractor (RAC) for Region 3, 4 and 5. These three contracts, awarded through a competitive procurement process, will support post-pay review of Medicare claims in these regions to efficiently identify and correct overpayments and underpayments made to health care providers with a focus on the quality, accuracy and transparency of reviews, the recovery of improper payments and the reduction of provider burden, Cotiviti says. “We are honored to continue our long-standing partnership with CMS by delivering our advanced technology, data analytics, and specialized expertise to support the RAC program, as well as continue to identify other opportunities to invest in our solutions and partnerships in the government market,” said Chris Coloian, executive vice president of Cotiviti, Inc. and general manager of Cotiviti GOV Services, LLC. In Region 3, which comprises eight states in the Southeast and two territories, and in Region 4, which comprises 17 states in the West and Mid-Atlantic, Washington, D.C., and three territories, Cotiviti is the incumbent contract holder. Performant, the RAC previously responsible for reviews in RAC Region 5, remains under contract with CMS to support the RAC program from an administrative and appeals perspective. In all the three regions, CMS anticipates Cotiviti will begin reviews in the summer. 

CHcc launches tools to promote hospital-at-home programs 

BOSTON – The Connected Health Collaborative Community (CHcc), which is co-hosted by the Digital Medicine Society (DiMe) and the Consume Technology Association, has launched its inaugural open-source resources to help scale hospital-at-home (HaH) programs to equip stakeholders with free tools to transition HaH from a temporary policy initiative to a permanent, sustainable model of care. Resources include: 

• A patient journey map 
• Technical and operational considerations 
• Program evaluation and reimbursement pathways, and 
• Pillars of successful implementation 

“At a time when government funding for health care is being reduced, hospital-at-home programs offer a lifeline to maintain access to essential services,” said Benjamin Vandendriessche, chief delivery officer, DiMe. “By delivering high-quality care in the home at a fraction of the cost of traditional hospital stays, these programs help health systems preserve critical services. Hospital-at-home is not just a cost-saving measure, it’s a sustainable model that protects patient care, supports frontline staff, and ensures communities continue to receive the care they need, even in a time of economic and policy uncertainty.” CHcc counts UMass Chan Medical School’s Program in Digital Medicine as founding Impact Sponsor.