Durable medical equipment provider AdaptHealth has agreed to pay $5.3 million to resolve allegations that the company submitted false claims to federal health care programs for respiratory devices that patients did not need or use.
AdaptHealth (NASDAQ: ACHO) of Plymouth Meeting admitted to no wrongdoing under the terms of the settlement.
Company officials were not immediately available for comment.
According to the U.S. Attorney's Office, the settlement resolves claims that from 2013 to 2017 AdaptHealth — then known as QMES and Tri-County Medical Equipment and Supply — itself and through related entities allegedly billed federal health insurance programs for non-invasive ventilators when a patient was instead prescribed and used a BiPAP machine. Federal health insurance payers reimburse suppliers thousands of dollars less per year for BiPAP machines than for ventilators.
The settlement also resolves allegations that AdaptHealth continued billing federal payers for ventilators after patients no longer needed or were using them, and double-billed federal payers for some ventilator rentals in violation of program requirements.
The settlement resolves a lawsuit originally brought by Michael J. Kelly, a former QMES employee, under the whistleblower provisions of the False Claims Act. Kelly will receive about $950,000 of the settlement.
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