Date: 08-17-2018

Case Style:

Case Number: 3:15-cv-00730-DRH-DGW

Judge: David R. Herndon

Court: United States District Court for the Southern District of Illinois (St. Clair County)

Plaintiff's Attorney: Mike Downey and Nicholas J Biersbach

Defendant's Attorney: No Available

Description: East St. Louis, IL - Durable Medical Equipment Provider Lincare Pays $5.25 Million to Resolve False Claims Act Allegations

Lincare, Inc., has paid $5.25 million to resolve allegations that it violated the federal False Claims Act and the Anti-Kickback Statute by offering illegal price reductions to Medicare beneficiaries, U.S. Attorney Steven D. Weinhoeft announced today. Headquartered in Clearwater, Florida, Lincare is one of the nation’s largest providers of oxygen and other respiratory therapy services to patients in the home, with approximately 1,000 locations across the United States.

The government alleged that, from 2011 to 2017, Lincare attempted to gain a competitive advantage in the marketplace by unlawfully waiving or reducing co-insurance, co-payments, and deductibles for beneficiaries who participated in a Medicare Advantage Plan operated through a private insurer. Lincare’s practices violated the Anti-Kickback Statute, and further caused the submission of false claims for payments to Medicare.

"Medicare is a promise to protect the elderly and disabled by providing health insurance to those who need it most. This office will aggressively defend Medicare to ensure that entities participating in government sponsored healthcare programs do so lawfully," said U.S. Attorney Weinhoeft. "This settlement reflects our commitment to maintain the integrity of the Medicare program."

"The Office of Inspector General will continue to aggressively investigate and pursue those who defraud public health care programs," said Steven Hanson, Special Agent in Charge Kansas City Regional Office, U.S. Department of Health and Human Services. "Greed at the expense of our most vulnerable citizens will not be tolerated."

The allegations were first brought to light in a 2015 whistleblower lawsuit filed by Brian Thomas, a former billing supervisor at Lincare. The False Claims Act permits private individuals to sue on behalf of the government for false claims and to share in any recovery. The civil lawsuit was filed in the Southern District of Illinois and is captioned United States ex rel. Brian Thomas v. Lincare Inc., Case No. 15-cv-00730-DRH. Mr. Thomas will receive $918,750 from the settlement proceeds.

This matter was handled by the U.S. Attorney’s Office for the Southern District of Illinois, the Justice Department’s Civil Division, and the Department of Health and Human Services Office of the Inspector General.

Outcome: Settled for $5.25 million.

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