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Home oxygen supply company settles healthcare fraud lawsuit

Many people in the Milwaukee area rely on medical device suppliers to provide needed equipment for their ongoing care. Home oxygen supplies are often necessary for individuals with respiratory conditions, including many forms of chronic obstructive pulmonary disease, to facilitate breathing. Medicare covers the rental costs for many patients who use stationary or portable equipment to supply oxygen.

The rules allow Medicare to cover the costs of rental equipment during the first 36 months with few restrictions on the need for the equipment. Once that period has lapsed, Medicare requires proof that the oxygen equipment is necessary and that the patient is actually using the equipment. A recently settled lawsuit alleged that a home medical equipment supplier in the Southwestern United States billed Medicare without the necessary proof that patients needed or used the equipment. The lawsuit further alleged the company may not have even provided oxygen to some patients, but billed Medicare for reimbursement anyway.

Former medical billing worker to receive more than $1.6M

A worker in the billing department of the medical supply company grew concerned about Medicare billing practices she observed while on the job. What steps she initially took to address the issue are not clear from a recent statement from the department of justice. However, she did decide to file a whistleblower lawsuit under the qui tam provision of the False Claims Act. Private individuals can file claims on behalf of the government when fraudulent billing practices are involved in government contracts. The former medical billing professional will receive roughly $1.6 million from a recent settlement between the government and the medical respiratory device supplier.

United States Attorney Joseph D. Brown of the Eastern District of Texas notes that Medicare fraud is not a victimless crime. He says that taxpayers bear the costs of fraud in government contracts. The effect of healthcare fraud also increases healthcare costs, according to the recent DOJ press release. In commending the whistleblower for coming forward with the evidence, Brown says, "because of her, we were able to recoup millions of dollars improperly paid to Rotech." Rotech is the medical respiratory device supplier. The company agreed to pay $9.68 Million to settle the case.

Many individuals have concerns about their rights after discovering potential fraud. If you believe that your employer is engaging in questionable billing practices related to a U.S. government agency, a seasoned whistleblower attorney can provide you with guidance and representation.

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