Consumer Fraud

Whistleblower’s False Claims Act Lawsuit Accuses Lincare Inc. of Defrauding Medicare

Pills Stethascope on Money 435x289 Whistleblower’s False Claims Act Lawsuit Accuses Lincare Inc. of Defrauding MedicareA False Claims Act lawsuit filed against medical equipment supplier Lincare Inc. by a whistleblower who accuses the company of bilking the U.S. government out of “tens, if not hundreds, of millions” of dollars was unsealed last week in a Florida federal court.

According to Law 360, Rebecca Saiff, a former Medicare billing specialist at Lincare, alleges that her former employer “incentivized employees at each of its stores to submit false claims” by paying store managers and salespersons commissions on claims whether or not those claims were qualified for reimbursement.

This practice allowed Lincare to bill the government for home oxygen equipment even when patients were away from home for extended periods. The company also failed to provide required repair services, billed Medicare for equipment rented to unqualified individuals, and double billed Medicare by submitting equipment rental charges with overlapping periods less than 30 days apart, even when they knew this to be in violation of Medicare rules, the whistleblower suit alleges.

“Rather than correcting store managers and/or sales persons, or simply dis-incentivizing the behavior by changing the commission structure, Lincare has instead opted to enrich itself by pressuring its billing personnel to push claims through to various insurers — including Medicare and Medicaid — that plainly should not be paid,” Ms. Saiff alleges.

Ms. Saiff, who worked at Lincare in 2013 and 2014, alleges she overheard a supervisor stating that in one month, these unlawful practices netted their Largo, Fla., regional billing office more than $23,000 in Medicare funds.

Ms. Saiff claims Lincare also picked up and redelivered equipment that didn’t need to be replaced in order to restart the three-year clock for monthly billing and ignored customer complaints of repair requirements when it was financially beneficial to do so.

According to the lawsuit, Ms. Lincare confronted her superiors when she knew her orders violated Medicare rules. “Relator resisted these instructions, and bluntly told her superiors that this behavior constituted Medicare fraud,” the lawsuit alleges. “Relator’s superiors responded that ‘this is the Lincare way.’”

Source: Law 360