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LEGAL NEWSLINE

Saturday, April 27, 2024

AG Moody’s Medicaid Fraud Control Unit Recovers Nearly $150,000 from Lincare Inc.

State AG
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Attorney General Ashley Moody | Office of Attorney General Ashley Moody

Attorney General Ashley Moody's Medicaid Fraud Control Unit has successfully secured almost $150,000 from Lincare Inc., a durable medical equipment supplier, following a multistate action. The settlement comes after allegations that Lincare knowingly submitted false claims to various government health care programs, including Medicaid, for rentals of non-invasive home ventilation devices.

Moody highlighted the seriousness of the situation, stating, "This medical equipment supplier billed Medicaid in multiple states for rentals of items that were not being used by patients." She further explained that Lincare's failure to monitor patients using home ventilation devices correctly led to unnecessary payouts by Florida Medicaid, resulting in a loss of taxpayer funds. Thanks to the efforts of the Medicaid Fraud Control Unit, Lincare is now reimbursing nearly $150,000 to Florida Medicaid.

The agreement addresses violations by Lincare between January 1, 2013, and February 29, 2020, under the federal and state False Claims Acts. It covers instances where Lincare provided medically unnecessary NIV rentals and failed to maintain adequate documentation to prove continued use or need, contravening both the False Claims Act and the company's internal policies.

The resolution stems from a whistleblower lawsuit filed in the United States District Court for the Southern District of New York, with Attorney General Moody's MFCU collaborating with the National Association of Medicaid Fraud Control Units in negotiations involving multiple states.

The Florida Attorney General’s Medicaid Fraud Control Unit plays a crucial role in combating Medicaid fraud, investigating providers engaging in fraudulent billing practices. Moody emphasized that Medicaid fraud not only defrauds the state's taxpayers but also investigates cases of patient abuse, neglect, and exploitation in facilities receiving Medicaid payments.

Funded through a grant from the U.S. Department of Health and Human Services-Office of Inspector General, the Florida MFCU received over $29 million for Federal Fiscal Year 2024, with a significant portion allocated to combating fraud and protecting the integrity of the Medicaid program.

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