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Tag: False Claims Act

Jeff Baird


Whistleblowers drive increase in FCA lawsuits

March 22, 2024Theresa Flaherty, Managing Editor

WASHINGTON – The False Claims Act has led to a growth industry of sorts and it’s unlikely to slow down any time soon, says health care attorney Jeff Baird.  The U.S. Department of Justice recently announced $2.68 billion in settlements and judgments under the FCA, its highest number in a single year, with more than $1.8 billion related to health care. The vast majority are driven by whistleblower lawsuits, says Baird, chairman of the Health Care Group at Brown & Fortunato.     “There...

False Claims Act, Jeff Baird, Whistleblower

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In brief: Rotech’s notification, DOJ’s fraud record, VGM’s CISO 

February 28, 2024HME News Staff

ORLANDO, Fla. – Rotech Healthcare on Feb. 23 provided notification of a recent privacy incident experienced by Philips Respironics that may have impacted certain information of patients who purchased Philips sleep and respiratory devices from Rotech.  “Although Rotech is unaware of any misuse of information resulting from this event, we are providing this notice in an abundance of caution,” the company stated on its website.  When reached for comment, a spokesman...

False Claims Act, Rotech Healthcare, VGM Group

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Cigna pays $172M to resolve FCA allegations

October 4, 2023HME News Staff

PHILADELPHIA – Cigna has agreed to pay $172 million to resolve allegations that it violated the civil False Claims Act by submitting and failing to withdraw inaccurate and untruthful diagnosis codes for its Medicare Advantage Plan enrollees to increase its payments from Medicare.   Cigna will pay about $135 million to resolve the allegations, with the remaining $37 million resolving allegations related to unsupported diagnoses for MA beneficiaries arising from Cigna’s home visit...

Cigna, False Claims Act, Medicare Advantage

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Lincare to pay $29M to settle False Claims Act violations

August 29, 2023HME News Staff

SPOKANE, Wash. – Lincare has agreed to pay $29 million settlement to resolve claims that violated the False Claims Act by overbilling Medicare and Medicare Advantage, according to a press release from Vanessa Waldref, the United States Attorney for the Eastern District of Washington.  The settlement requires Lincare to refund wrongful payments made by Medicare beneficiaries and sets up accountability measures to prevent future fraudulent billing.  In the settlement announced...

False Claims Act, Home Oxygen Equipment, Lincare

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AdaptHealth resolves alleged false claims violations 

April 24, 2023HME News Staff

PHILADELPHIA – AdaptHealth will pay $5.3 million to resolve alleged False Claims Act violations for submitting allegedly false claims to federal health care programs for respiratory devices that patients did not need or use, according to the U.S. Attorney’s Office for the Eastern District of Pennsylvania.   The settlement resolves allegations that between 2013 and 2017 AdaptHealth, known at the time as QMES and Tri-County Medical Equipment and Supply, knowingly and willfully...

AdaptHealth, False Claims Act, Non-invasive ventilators

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DOJ recoups $2.2B under False Claims Act

February 8, 2023HME News Staff

WASHINGTON – Settlements and judgments under the False Claims Act exceeded $2.2 billion in the fiscal year ending Sept. 30, 2022, according to the Department of Justice.  The government and whistleblowers were party to 351 settlements and judgments, the second-highest number of settlements and judgments in a single year. Recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, now total more than $72 billion.  “Protecting taxpayer dollars...

False Claims Act

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Respironics settles for $24M 

September 1, 2022HME News Staff

PITTBURGH – Philips Respironics has agreed to pay more than $24 million to resolve False Claims Act allegations that it misled federal health care programs by paying kickbacks to DME suppliers, the U.S. Department of Justice has announced.  The settlement resolves allegations that Respironics caused DME suppliers to submit claims for ventilators, oxygen concentrators, CPAP and BiPAP machines, and other respiratory related medical equipment that were false because the company provided...

False Claims Act, Philips Respironics, Settlement

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Also Noted

Lincare pays $5.25M to resolve allegations

August 21, 2018HME News Staff

CLEARWATER, Fla. - Lincare has paid $5.25 million to resolve allegations that it violated the federal False Claims Act and the Anti-Kickback Statute by offering illegal price reductions to Medicare beneficiaries, according to the U.S. Attorney's Office for the Southern District of Illinois. The government alleged that, from 2011 to 2017, Lincare attempted to gain a competitive advantage in the market by unlawfully waiving or reducing co-insurance, co-payments and deductibles for beneficiaries who...

Anti-Kickback Statute, False Claims Act, Lincare, Settlement

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Rotech agrees to pay $9.68M

April 13, 2018HME News Staff

CLEARWATER, Fla. - Rotech Healthcare has agreed to pay $9.68 million for submitting false claims for portable oxygen contents to Medicare, according to an April 12 press release from the Department of Justice. As part of the settlement, Rotech admitted to billing portable oxygen contents to Medicare for beneficiaries who did not use or require them. Additionally, the company admitted to billing Medicare regardless of whether such contents were delivered, the release states. “This settlement...

False Claims Act, Lawsuit, Rotech Healthcare, Settlement, Whistleblower

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Specialty Providers

Sleep clinic agrees to pay $2.6M for dual role

December 30, 2016HME News Staff

SAN JOSE, Calif. - Bay Sleep Clinic and its related businesses have agreed to pay $2.6 million to settle allegations that they were involved in both the diagnosis and treatment of sleep patients, a violation of Medicare rules and regulations.The government charged Bay Sleep Clinic and its related businesses—Qualium Corp., which operates 20 sleep clinics, and Amerimed Corp., which does business as Amerimed Sleep Diagnostics and Amerimed CPAP Specialist—with fraudulently billing Medicare...

False Claims Act, Settlement, Sleep Therapy

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