Montco Company Must Pay $5.3M For Healthcare Fraud: Feds

PLYMOUTH MEETING, PA — A Plymouth Meeting-based medical supply filed some $5.3 million in false claims to federal programs for respiratory devices that patients did not require, according to the U.S. Attorney's Office.

AdaptHealth, formerly known as QMES and headquartered on 220 W. Germantown Pike, had its fraud outed by a whistleblower.

“The integrity of our health care system depends on the government being able to rely on durable medical equipment providers to seek reimbursement for only those devices a doctor has prescribed for their patient and that the patient actually needs and uses,” Jacqueline Romero, the U.S. Attorney for the Eastern District of Pennsylvania, said in announcing the settlement.

Adapt was investigated through the False Claims Act, which allows a whistleblower to bring a lawsuit forth on behalf of the United States government. For assisting the government in prosecuting the fraud, the former employee, Michael Kelly, will receive $950,000 through the settlement.

Federal officials said that Adapt billed the government programs for non-invasive breathing ventilators, when patients were actually prescribed the less expensive BiPAP machine.

Adapt also continued to bill the government for hte ventaliators even after patients no longer needed the machines, according to authorities.

Assistant U.S. Attorneys Lauren DeBruicker and Veronica J. Finkelstein, along with Auditor Dawn Wiggins, led the case.

Any tips on healthcare fraud, waste, abuse, and mismanagement should be reported to the U.S. Department of Health and Human Services through their tip line at 800-HHS-TIPS (800-447-8477).