Lincare Inc., a major U.S. supplier of medical oxygen and other respiratory therapies, has agreed to pay the U.S. $5.25 million to settle a whistleblower lawsuit alleging it violated the federal False Claims Act and Anti-Kickback Statute by offering illegal discounts to Medicare beneficiaries.
Based in Clearwater, Florida, Lincare operates about 1,000 locations across the U.S. According to a False Claims Act lawsuit filed by whistleblower Brian Thomas and supported by the federal government, Lincare attempted to gain a competitive edge in the marketplace by unlawfully waiving or reducing co-insurance, co-payments, and deductibles for beneficiaries who participated in a Medicare Advantage Plan operated through a private insurer.
Federal prosecutors who investigated Mr. Thomas’ whistleblower complaint confirmed that Lincare’s business practices violated the Anti-Kickback Statute and caused the submission of false claims to Medicare for reimbursements. The unlawful practices continued from 2011 to 2017, investigators determined.
“Medicare is a promise to protect the elderly and disabled by providing health insurance to those who need it most. This office will aggressively defend Medicare to ensure that entities participating in government-sponsored health care programs do so lawfully,” said U.S. Attorney Steven D. Weinhoeft in an announcement of the settlement. “This settlement reflects our commitment to maintain the integrity of the Medicare program.”
The Health and Human Services Department’s Office of Inspector General offered a similar take on the case and vowed to “aggressively investigate and pursue those who defraud public health care programs.”
“Greed at the expense of our most vulnerable citizens will not be tolerated,” said Steven Hanson, Special Agent in Charge Kansas City Regional Office, U.S. Department of Health and Human Services.
Mr. Thomas, who formerly worked as a billing supervisor at Lincare, filed the lawsuit under the whistleblower provisions of the False Claims Act, which authorizes private parties to sue on behalf of the U.S. government in cases of suspected fraud targeting taxpayer-funded agencies and programs.
Whistleblowers whose False Claims Act lawsuits result in a settlement or judgment are awarded 15-25 percent the total recovery. Mr. Thomas will receive about $919,000 as a whistleblower award.