Durable Medical Equipment (DME) supplier Lincare has reached a $25.5 million settlement to resolve allegations over fraudulent billing practices.
The U.S. Attorney’s Office for the Southern District of New York, along with members of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), announced the settlement on Feb. 15.
“Individuals and entities that participate in the federal health care system are required to obey the laws meant to preserve the integrity of program funds and the provision of appropriate, quality services to patients,” HHS-OIG Special Agent in Charge Naomi Gruchacz said in the announcement. “Our agency, working closely with our law enforcement partners, will continue to hold health care providers responsible for receiving improper payments from federal health care programs.”
Lincare is one of the largest providers of respiratory equipment, serving roughly 1.8 million patients across its U.S. footprint. Its parent company is Linde PLC, a global industrial gas and engineering company with 2021 sales of $31 billion.
The company employs roughly 11,000 individuals, including 1,300 clinicians, according to Lincare’s website. It has more than 700 locations in 48 states.
Lincare did not respond to a request for comment from HME Business.
Specifically, the $25.5 million settlement resolves allegations that Lincare violated the False Claims Act (FCA) by continuing to bill federal health care programs for the rental of costly non-invasive ventilators (NIVs) when patients no longer needed or used the devices.
The settlement also resolves claims that the DME giant violated the Anti-Kickback Statute by waiving coinsurance payments to induce certain Medicare and TRICARE beneficiaries to rent NIVs.
“When DME suppliers like Lincare knowingly seek federal funds for items that are not medically necessary and not being used, they threaten the sustainability and financial integrity of vital federal health care programs like Medicare and Medicaid,” U.S. Attorney Damian Williams said in the announcement.
The $25.5 million settlement will be split between states and the federal government, with the vast majority of the money – about $24.2 million – going to the feds.
In health care, settling FCA cases is often viewed as a cost of doing business. Settling allegations – regardless of any admission of guilt – is usually more cost effective than continuing to battle them.
As part of its settlement, however, Lincare admitted that it received reimbursement from federal health care programs for some NIV rental claims that did not comply with billing rules and guidance.
The company, according to the U.S. Attorney’s Office for the Southern District of New York, also admitted that, in some instances, it continued to seek monthly payments when it was aware that patients were not using its devices.
Lincare was also part of a $29 million settlement in 2023.
