Acting United States Attorney Alexander C. Van Hook announced that Shreveport Prosthetics, Inc. (“SPI”) has agreed to pay $1.6 million, plus interest, to the federal government to resolve allegations that it violated the False Claims Act for false supplier billings to the Medicare program.
SPI is a Louisiana corporation that provides upper and lower extremity prosthetics to patients in North Louisiana. The civil settlement resolves allegations that when SPI’s supplier number was deactivated, SPI funneled its claims to Medicare through a supplier in Texas for services that were rendered by SPI in Louisiana. SPI also routinely waived patient coinsurance amounts over a three year period, resulting in Medicare being overcharged for the billed services. This lawsuit was initiated by former office administrator/billing specialist Kimberly Throgmorton under the qui tam, or whistleblower provisions, of the False Claims Act. Under the False Claims Act, private citizens can bring suit on behalf of the United States and share in any recovery. Ms. Throgmorton will receive over a quarter of a million as her share of the government’s recovery.
“The U.S. Attorney’s Office is committed to investigating and aggressively pursuing healthcare providers who seek public funds through unlawful means. This settlement should send a message to all healthcare providers and suppliers in the Western District of Louisiana that violations of the False Claims Act will continue to receive this office’s full attention and resources,” said Alexander C. Van Hook, Acting U.S. Attorney.
“We remain focused on investigating healthcare providers who seek to enrich themselves by engaging in illegal activities,” said Miranda L. Bennett, Special Agent in
Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “We will continue working with our law enforcement partners to investigate these types of insidious schemes, which are designed to bypass important protections for Medicare beneficiaries.”
As part of the settlement, SPI agreed to a three-year Integrity Agreement (IA) with the Office of Inspector General (OIG). The IA promotes compliance with the statutes, regulations, program requirements, and written directives of Medicare and all other federal health care programs. Among other compliance obligations, the IA requires that SPI must establish and maintain a compliance program, engage an Independent Review Organization to perform quarterly claims reviews, and routinely report on these obligations to OIG.
This resolution is part of the government’s emphasis on combating health care fraud. The Department of Justice and the Department of Health and Human Services work in partnership to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
The case is docketed as United States ex rel. Throgmorton v. Shreveport Prosthetics, Inc., et al., No. 17-881 (W.D. La.).
The U.S. Department of Health and Human Services, Office of Inspector General, conducted the investigation of this case. Assistant U.S. Attorney Karen J. King prosecuted the case.