United States Attorney Deirdre M. Daly and Connecticut Attorney General George Jepsen announced that J&L Medical Services has entered into a civil settlement agreement with the federal and state governments in which it will pay $600,000 to resolve allegations that it violated the federal and state False Claims Acts.
J&L Medical is a durable medical equipment company located in Middlebury, Connecticut. As part of its business, J&L Medical provides CPAP and BiPAP devices and accessories to Medicare and Medicaid beneficiaries who have been diagnosed with obstructive sleep apnea.
It is alleged that J&L Medical regularly utilized the services of unlicensed technicians to provide respiratory therapy services to Medicare and Medicaid beneficiaries, including setting up CPAP and BiPAP machines, fitting the patients with the masks used with those machines, and educating the patients about the use of the machines.
Under Connecticut law, the practice of respiratory therapy is a licensed activity. It is alleged that the respiratory therapy services in question could only be legally performed by licensed respiratory therapists.
To resolve the allegations under the federal and state False Claims Acts, J&L Medical has agreed to pay $600,000, which covers conduct occurring from January 1, 2008 through May 15, 2013.
As part of the settlement, J&L Medical also agreed to implement a compliance program intended to prevent and/or detect fraud, waste, and abuse in claims submitted by the company to the Connecticut Medicaid program.
A complaint against J&L Medical was filed in the U.S. District Court in Connecticut under the qui tam, or whistleblower, provisions of the both the federal and state False Claims Acts. The relator (whistleblower), John Hart, a former employee of J&L Medical and a licensed respiratory therapist, will receive a share of the proceeds of the settlement in the amount of $102,000.
The whistleblower provisions of both the federal and state False Claims Acts provide that the whistleblower is entitled to receive a percentage of the proceeds of any judgment or settlement recovered by the government.
“Healthcare providers must utilize properly licensed individuals to treat Medicare and Medicaid patients, and the failure to do will have serious consequences,” says Daly in a release. “The U.S. Attorney’s office is committed to vigorously pursuing health care providers who submit false or fraudulent claims to federal health care programs.”
Jepsen says, “My office is committed to protecting Connecticut’s healthcare programs—as well as the taxpayers who fund them—from fraud. By bringing state False Claims Act cases such as this, we recover funds obtained through fraud and deter others from attempting similar schemes. I appreciate the continued coordination with our state and federal law enforcement partners to ensure that our most vulnerable citizens and our taxpayer interests are protected.”
This matter was investigated by the Office of Inspector General for the Department of Health and Human Services and the Federal Bureau of Investigation. The case is being prosecuted by Assistant U.S. Attorney Richard M. Molot and Auditor Kevin Saunders, and by Assistant Attorney General Robert B. Teitelman, and Forensic Fraud Examiners Larry Marini and David Bouchard, of the Connecticut Office of the Attorney General.
People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.