MM Curator summary
[MM Curator Summary]: They juiced the pricing and the shipping charges to get $363k more than they should have.
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OKLAHOMA CITY – Attorney General John O’Connor announced today that a former Oklahoma-based company, Tri State Medical Supplies, LLC, has agreed to resolve allegations that the company violated the Oklahoma Medicaid False Claims Act by inflating prices and shipping charges of durable medical equipment. Tri-State Medical Supplies has agreed to pay $363,116 to resolve the allegations.
Tri-State Medical Supplies provided durable medical equipment and other services to Oklahoma Medicaid beneficiaries through a program administered by the Oklahoma Department of Human Services Developmental Disabilities Services Division. The settlement resolves certain allegations that Tri-State submitted claims to the Oklahoma Medicaid program, known as “SoonerCare,” based on inflated pricing and shipping charges.
“The Oklahoma attorney general’s office will always aggressively investigate these cases and partner with our local, state and federal agencies to ensure those who commit Medicaid and Medicare fraud are held accountable,” said Attorney General O’Connor.
The Oklahoma Medicaid Fraud Control Unit (MFCU) began investigating Tri-State after receiving a referral from a program manager at OKDHS Developmental Disabilities Services Division (DDSD). The DDSD works with clients who are physically challenged. The program manager became suspicious when the claims of Tri-State were compared to claims from other companies that provided similar services and equipment.
“I commend our Medicaid Fraud Control Unit for successfully investigating this case and OKDHS Developmental Disabilities Services Division (DDSD) for their employee’s referral,” said Attorney John O’Connor.
The Oklahoma Attorney General’s Office Medicaid Fraud Control Unit has statewide jurisdiction to investigate and prosecute violations of state and federal laws pertaining to provider fraud in the administration of the Oklahoma Medicaid program. Additionally, the MFCU investigates and prosecutes qui tam, or “whistleblower” allegations in Oklahoma and nation-wide, and frequently partners with other states’ MFCUs and United States Attorneys’ offices.
The MFCU also investigates and prosecutes cases of abuse, neglect, drug diversion, and financial exploitation involving residents in long-term board and care facilities, as well as, in some circumstances, residential care settings. In this role, the MFCU serves as a safeguard against caretakers who abuse, neglect, or exploit vulnerable Oklahomans.