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[MM Curator Summary]: Phillips RS North America will pay $24M for its scam that paid DME companies kickbacks in the form of data that was valuable for marketing and sales.
Delaware News
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Delaware has joined with other states and the federal government to reach an agreement in principle with Philips RS North America LLC, (formerly known as Respironics Inc.), a manufacturer of durable medical equipment (DME) based in Pittsburgh, Pennsylvania, to resolve federal False Claims Act and Delaware False Claims and Reporting Act (DFCRA) allegations that it misled federal health care programs by paying kickbacks to DME suppliers.
Respironics has agreed to pay over $24 million to resolve the allegations that affected Medicare, Medicaid and TRICARE, which is the health care program for active military and their families. Of the total settlement amount, $4,826,250.00 will go to the Medicaid program. Delaware’s Medicaid program will receive $55,688.54.
“Kickbacks result in improper claims being filed with Medicaid and other healthcare benefit programs, and drain precious resources that Medicaid recipients rely on,” Attorney General Jennings said. “We will continue fighting against fraud, waste, and abuse against the government.”
The settlement resolves allegations that from November 1, 2014 through April 30, 2020, that Respironics caused DME suppliers to submit false claims to the Medicaid program for ventilators, oxygen concentrators, CPAP and BiPAP machines, and other respiratory-related medical equipment, when such claims were tainted by Respironics’ providing unlawful remuneration to these DME suppliers in the form of physician prescribing data (known as “HMS” or “Health Market Science data”), free of charge, knowing that this data may be of significant value to DME suppliers in their own marketing efforts.
This settlement arises from a qui tam action originally filed in October of 2019 and then amended in November of 2019 in the United States District Court for the District of South Carolina under the federal False Claims Act and various states’ statutes, including the DFCRA.
Delaware, along with representatives from the Offices of the Attorneys General for the states of Florida, Illinois, Indiana, New York, Pennsylvania, Tennessee, and Washington, assisted in leading a National Association of Medicaid Fraud Control Units (NAMFCU) team during the investigation and settlement negotiations with Respironics on behalf of the states.
The Attorney General’s Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $2,023,800 for Federal FY 2022. The remaining 25 percent, totaling $674,595 for FY 2022, is funded by Delaware.
Keep up to date by receiving a daily digest email, around noon, of current news release posts from state agencies on news.delaware.gov.
Here you can subscribe to future news updates.
Delaware to Receive Nearly $56,000 for Alleged False Claims Caused by Respiratory-Related Medical Equipment
Featured Posts | News | Date Posted: Wednesday, January 11, 2023
Delaware has joined with other states and the federal government to reach an agreement in principle with Philips RS North America LLC, (formerly known as Respironics Inc.), a manufacturer of durable medical equipment (DME) based in Pittsburgh, Pennsylvania, to resolve federal False Claims Act and Delaware False Claims and Reporting Act (DFCRA) allegations that it misled federal health care programs by paying kickbacks to DME suppliers.
Respironics has agreed to pay over $24 million to resolve the allegations that affected Medicare, Medicaid and TRICARE, which is the health care program for active military and their families. Of the total settlement amount, $4,826,250.00 will go to the Medicaid program. Delaware’s Medicaid program will receive $55,688.54.
“Kickbacks result in improper claims being filed with Medicaid and other healthcare benefit programs, and drain precious resources that Medicaid recipients rely on,” Attorney General Jennings said. “We will continue fighting against fraud, waste, and abuse against the government.”
The settlement resolves allegations that from November 1, 2014 through April 30, 2020, that Respironics caused DME suppliers to submit false claims to the Medicaid program for ventilators, oxygen concentrators, CPAP and BiPAP machines, and other respiratory-related medical equipment, when such claims were tainted by Respironics’ providing unlawful remuneration to these DME suppliers in the form of physician prescribing data (known as “HMS” or “Health Market Science data”), free of charge, knowing that this data may be of significant value to DME suppliers in their own marketing efforts.
This settlement arises from a qui tam action originally filed in October of 2019 and then amended in November of 2019 in the United States District Court for the District of South Carolina under the federal False Claims Act and various states’ statutes, including the DFCRA.
Delaware, along with representatives from the Offices of the Attorneys General for the states of Florida, Illinois, Indiana, New York, Pennsylvania, Tennessee, and Washington, assisted in leading a National Association of Medicaid Fraud Control Units (NAMFCU) team during the investigation and settlement negotiations with Respironics on behalf of the states.
The Attorney General’s Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $2,023,800 for Federal FY 2022. The remaining 25 percent, totaling $674,595 for FY 2022, is funded by Delaware.
Keep up to date by receiving a daily digest email, around noon, of current news release posts from state agencies on news.delaware.gov.
Here you can subscribe to future news updates.