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Medical Devices and DME

This archive displays posts tagged as relevant to medical devices and durable medical equipment. You may also be interested in our pages:

Page 1 of 19

New York Doctor Indicted for $20.7 Million in Medicare Fraud and Kickback Scheme

Posted  02/23/24
doctor with dollars

On February 21, 2024, a federal grand jury in New Jersey indicted Dr. Alexander Baldonado, of Queens, New York, for his alleged involvement in a complex health care fraud and illegal kickback scheme. According to the DOJ press release, this scheme involved the submission of over $20.7 million in false and fraudulent claims to Medicare, primarily for medically unnecessary genetic cancer screening and Covid-19...

Tagged in: FCA Federal, Government Programs Fraud, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Medical Devices and DME, Medicare, Provider Fraud, Reporting to Government,

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Catch of the Week: Lincare, Inc.

Posted  02/16/24
DOJ website magnified logo
This week's Department of Justice (DOJ) Catch of the Week goes to Lincare, Inc., a durable medical equipment supplier with locations throughout the country.  Yesterday (February 15), the company agreed to pay $25.5 million to settle DOJ charges of violating the False Claims Act by billing Medicare for the rental of non-invasive ventilators (NIVs) when patients no longer needed or used them.  DOJ also charged Lincare...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medicaid, Medical Devices and DME, Medicare, Other Government Health Programs, Whistleblower Case,

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January 31, 2024

In the fourth-largest Controlled Substances Act (CSA) settlement in history, e-commerce company eBay has agreed to pay $59 million for its failure to properly regulate the sales of pill presses and encapsulating machines on its website.  Such devices can be used to produce pills that mimic pills produced by legitimate pharmaceutical companies.  To combat this, the CSA requires that purchasers of such devices have their identities verified, recorded, and reported to the DEA; however, eBay failed to do so.  DOJ

Tagged in: Healthcare Fraud, Medical Devices and DME,

December 21, 2023

A Florida woman who submitted over $192 million in claims to Medicare for medically unnecessary and unprovided tests, equipment, and services, has been sentenced to 20 years in prison.  Elizabeth Hernandez ordered thousands of genetic testing and orthotic braces for patients she never spoke to or examined, ultimately ordering more cancer genetic tests than any other provider in the nation.  She also billed for thousands of telemedicine visits that she never performed, often billing for over 24 hours in a single day.  DOJ

Tagged in: Criminal Proceedings, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Devices and DME, Medicare,

December 18, 2023

Heart monitoring device manufacturer BioTelemetry Inc. and its subsidiary, LifeWatch Services Inc., have agreed to pay more than $14.7 million for causing false claims to be submitted to federal healthcare programs.  The claims were brought in two separate qui tam suits, one by an employee of one of LifeWatch’s customers, Michael Pelletier, and the other by SFP I LLC.  The whistleblowers alleged that the companies knew the design of their enrollment portal would steer clinical staff into enrolling patients in telemetry, which is reimbursed at a higher rate, rather than holter monitoring and event monitoring, which is reimbursed at a lower rate.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medical Devices and DME, Medicare, Other Government Health Programs, Whistleblower Case,

Nurse Practitioner Convicted in $200 Million Medicare Fraud Scheme

Posted  09/28/23
Stethoscope Placed Down
In a landmark healthcare fraud case, a federal jury in Miami has convicted a nurse practitioner $200 million for her central role in a massive Medicare fraud scheme in which she conspired with telemarketing companies to submit false claims for unnecessary genetic testing and medical equipment. Evidence presented during trial outlined the scheme: telemarketers targeted Medicare beneficiaries, and pressured them to...

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Devices and DME, Medicare,

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May 11, 2023

Dutch medical supplier Koninklijke Philips N.V. has agreed to pay $62 million to settle charges that it violated the Foreign Corrupt Practices Act while selling medical equipment to hospitals in China.  A SEC investigation found that Philips’ Chinese subsidiaries gave distributors special pricing discounts that invited excessive funds to be used for improper payments, made such payments to curry favor toward their products, and manipulated the fair bidding process to fake compliance with Chinese laws.  The SEC had previously charged Philips for similar conduct in Poland between 1999 and 2007.  SEC

Tagged in: FCPA, Medical Devices and DME,

April 20, 2023

Matthew Taylor Witkowski will spend 60 months in prison for generating and purchasing fraudulent written orders for DME, and then, using his Dominican Republic-based business, marketed and sold those orders to pharmacies and DME suppliers. Witkowski’s fraud resulted in more than $8 million in false claims reimbursements being made by Medicare. Witkowski will forfeit over $4 million and pay restitution of over $8 million to Medicare. SDNY

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medical Devices and DME, Medicare, Provider Fraud,

April 20, 2023

Miami doctors Lawrence Alexander and Dean Zusmer were sentenced to 33 months and 96 months in prison, respectively, for their scheme to defraud Medicare of $31 million. Zusmer, a chiropractor and DME company owner, paid kickbacks to acquire patient referrals and signed doctors’ orders, using overseas call centers to solicit unnecessary prescriptions from patients and telemedicine companies. Alexander, an orthopedic surgeon and co-owner of another DME company, concealed his participation by putting the DME company in the name of one of his family members. The companies received over $15 million from Medicare through their fraud. DOJ

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Devices and DME, Medicare, Provider Fraud,

February 13, 2023

Spacelabs Healthcare, LLC has agreed to pay $2.5 million to settle claims of violating the False Claims Act by overcharging the Department of Veteran Affairs and Department of Defense between 2014 and 2019.  According to a qui tam suit filed by two former Spacelabs employees, Marci Gebhardt and Christopher Kelley, the company agreed to contract clauses in which they would sell patient monitoring equipment to the government at lower rates.  However, Spacelabs then failed to comply when billing the VA and Defense Logistics Agency.  For their role in bringing a successful enforcement action, Gebhardt and Kelley will share in a $437,500 reward.  DOJ

Tagged in: FCA Federal, Government Procurement Fraud, Healthcare Fraud, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

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