Last week’s enforcement actions continued a trend we’ve seen over our past few Weekly Enforcement Reports—a lack of lab-related cases. However, two medical centers and a medical equipment company paid big to settle various allegations, the largest being a $7 million settlement to resolve alleged False Claims Act violations.
Key Healthcare-Related Enforcement Actions Announced from March 1 – March 8, 2023
|Date Action Announced||Defendant(s)||Allegations/Charges/Convictions||Result|
|March 1||United Seating and Mobility, LLC, d/b/a Numotion (Numotion)||Durable medical equipment supplier allegedly did not reveal all the discounts it received from or the prices it actually paid to DME manufacturers when billing Kentucky Medicaid, two Kentucky Medicaid MCOs (Aetna Better Health of Kentucky and WellCare of Kentucky), MO HealthNet, and D.C. Medicaid. This failure allegedly led to these payors paying the company “higher reimbursements than it was entitled to receive,” thus violating the federal False Claims Act.||Settled for $7 million. Numotion has also entered a 5-year Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General.1|
|March 2||Michael BrierMi Ok BruiningRecovery Connections Centers of America, Inc. (RCCA)||Addiction treatment chain and its operators are charged with healthcare fraud for failing to provide their patients with needed treatment and counseling services while billing federal healthcare programs and other payor millions of dollars for these services. Brier is also charged with obstruction, money laundering, and aggravated identity theft.||Case is yet to be prosecuted, but the government is looking to forfeit two vehicles, two buildings, and 13 bank accounts that are connected to the alleged scheme.2|
|March 3||Lakeland Regional Medical Center (LRMC)||The Florida-based medical center allegedly made improper donations to Polk County, Florida “by assuming and paying certain of Polk County’s financial obligations to other healthcare providers.” These donations were meant to increase LRMC’s Medicaid payments, the US alleges.||Settled for $4 million.3|
|March 7||Penn State Health (PSH)||In a case that came about due to a voluntary disclosure from PSH, the health system allegedly billed Medicare Part B for evaluation & management (E&M) services that “were not supported by the medical record on the same date of service as infusion services.” However, when the billing issues were discovered, PSH “took prompt corrective action.”||Settled for $1,252,662.28.4|