Kentucky-based medical equipment provider Oxygen Plus, Inc. will pay $200,000 to settle allegations of violating the False Claims Act by billing Medicare and Medicaid for unnecessary or unused respiratory devices in patients’ treatment.
Designed for patients with respiratory disease, Oxygen Plus provides patients with home-use non-invasive ventilators (NIV) that deliver pressurized air to the lungs. The company allegedly submitted over 300 false claims to Medicare and Kentucky Medicaid between January 2017 and June 2021, filing for reimbursement for NIV rentals for patients who no longer needed or used the device.
The lawsuit was filed by two former employees under the False Claims Act’s qui tam provisions. Qui tam permits private citizens with knowledge of fraud, corporate or individual, against the government to bring forth a lawsuit on behalf of the United States and are eligible to receive shares between 15 and 30% of the government’s recovery. In this suit, the whistleblowers are set to receive $32,000 from the $200,000 settlement.
This settlement came about through the collaboration of the U.S. Attorney’s Office’s Affirmative Civil Enforcement section and the U.S. Department of Health and Human Services, Office of Inspector General. There has been no determination of liability in the suit – the claims addressed by the settlement are allegations.
The False Claims Act is a powerful tool in the government’s combat of healthcare fraud and whistleblowers are key to the law’s efficacy.
On July 25, a bipartisan group of senators introduced the False Claims Amendments Act of 2023, which address a few technical loopholes undermining the success of the FCA. The bill is widely supported by whistleblower advocates.
“The False Claims Act is America’s number one fraud-fighting law,” said whistleblower attorney Stephen M. Kohn. “These amendments are urgently needed to ensure that whistleblowers can continue to play their key role in protecting taxpayers from corporate criminals.”
Further Reading:
Bipartisan Legislation Unveiled to Strengthen False Claims Act