MM Summary- A medical equipment company stole $40M from Florida Medicaid by billing for unnecessary ventilators.
Apria Healthcare, a medical equipment provider with more than 300 offices across the U.S., will pay $40 million to settle billing fraud allegations, the Florida attorney general’s office said.
According to prosecutors, Apria submitted false claims to state Medicaid programs for noninvasive ventilators that patients didn’t use or were not medically necessary. The alleged billing fraud took place from January 2014 to December 2019.
The allegations were originally brought under the whistleblower provisions of the federal False Claims Act.
“We will not allow bad actors to falsify forms or blatantly bill Florida taxpayers for services never rendered or not medically necessary. I am proud of the role my Medicaid Fraud Control Unit played in investigating this multimillion dollar fraudulent billing scheme inflicted on taxpayers in Florida and across our country, and the recovery of more than $40 million,” said Florida Attorney General Ashley Moody.
“We are pleased to have resolved this civil matter and fully cooperated throughout the review. This settlement relates primarily to whether patients made sufficient use of non-invasive ventilators, prescribed by physicians for use in patients’ homes, and was based largely on data from the early years of the company’s NIV program. Prior to becoming aware of the government’s interest in the matter in 2017, Apria had already made a number of changes to the NIV program’s processes and procedures relating to patient usage in the home. As always, our patients are our top priority and we remain committed to providing outstanding care and exceptional service,” an Apria spokesperson told Becker’s Hospital Review.