United States Attorney Jacqueline C. Romero announced on April 21st that Plymouth Meeting-based AdaptHealth LLC (formerly known as QMES, LLC) will “pay $5.3 million to resolve alleged False Claims Act violations for submitting allegedly false claims to federal healthcare programs for respiratory devices that patients did not need or use, in violation of federal healthcare program requirements. The company is a provider of durable medical equipment.
From the announcement:
The settlement resolves allegations that between 2013 and 2017, AdaptHealth (known during the period as QMES and Tri-County Medical Equipment and Supply LLC), itself and through certain of its related entities, 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. The settlement also resolves allegations that AdaptHealth continued billing federal payors for ventilators after patients no longer needed or were using them, and double-billed federal payors for some ventilator rentals in violation of program 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,” said U.S. Attorney Romero. “Providers like AdaptHealth have an...
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