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 billed federal payers for non-invasive ventilators when a patient was, instead, prescribed and used a BiPAP machine, which is reimbursed at thousands of dollars less per year.

It also resolves allegations that the company continued billing federal payers for vents after patients no longer needed or were using them, and double-billed those payers for some vent rentals in violation of program requirements.

The settlement resolves a lawsuit originally brought by Michael J. Kelly, a former QMES employee, under the whistleblower, or qui tam, provisions of the False Claims Act. He will receive approximately $950,000 of the settlement.

The claims resolved by the settlement are allegations only; there has been no determination of liability.

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