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Medical equipment provider pays $5.25M penalty for Medicare fraud

St. Louis Post-Dispatch - 8/17/2018

Aug. 17--A medical equipment provider accused of giving illegal price reductions to Medicare beneficiaries has paid $5.25 million to resolve the allegations.

The agreement was announced Thursday by U.S. Attorney Steven D. Weinhoeft of the Southern District of Illinois.

Florida-based Lincare Inc. is one of the nation's largest providers of oxygen and other respiratory therapy services at home, and has about 1,000 locations across the United States.

The government claims that from 2011 to 2017, Lincare violated the federal False Claims Act and the Anti-Kickback Statute by unlawfully waiving or reducing co-payments, co-insurance and deductibles for beneficiaries who were a part of a Medicare Advantage Plan operated through a private insurer. The company's goal was "to gain a competitive advantage in the marketplace," the prosecutor said.

The practices led to the submission of false claims for payments to Medicare, a press release from Weinhoeft said.

The allegations were first brought to light by a whistleblower who formerly worked for the company as a billing supervisor. The whistleblower will receive $918,750 from the settlement proceeds.

"The Office of Inspector General will continue to aggressively investigate and pursue those who defraud public health care programs," Steven Hanson, an investigator with the U.S. Department of Health and Human Services, said in a press release. "Greed at the expense of our most vulnerable citizens will not be tolerated."

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