PENNSYLVANIA (WTAJ) — Pennsylvania-based AdaptHealth LLC will have to pay over $5 million for allegedly submitting false claims to federal healthcare programs, according to the Department of Justice (DOJ).
AdaptHealth LLC, formerly known as QMES, LLC, will have to pay $5.3 million to resolve alleged False Claims Act violations for allegedly submitting false claims to federal healthcare programs for respiratory devices that patients did not need or use.
AdaptHealth LLC is a provider of durable medical equipment based out of Plymouth Meeting, Pennsylvania.
The settlement resolves allegations between 2013 and 2017 where AdaptHealth (known at this time as QMES and Tri-County Medical Equipment and Supply LLC), knowingly and willfully billed federal payors for non-invasive ventilators (NIVs) when a patient was instead prescribed and used a BiPAP machine, for which federal payors reimburse suppliers thousands of dollars less per year, according to the DOJ.
This also resolved allegations that AdaptHealth continued to bill federal payors for ventilators after patients no longer needed or were using them and/or double-billed federal payers for some ventilator rentals in violation of the program’s requirements.
“The integrity of our health care system depends on the government being able to rely on durable medical equipment providers to seek reimbursement for only those devices a doctor has prescribed for their patient and that the patient actually needs and uses,” U.S. Attorney...
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