For Lincare, paying multimillion-dollar authorized settlements is an integral a part of doing enterprise.

The corporate, the biggest distributor of house oxygen tools in the USA, admitted billing Medicare for ventilators it knew clients weren’t utilizing (2024) and overcharging Medicare and 1000’s of aged sufferers (2023). It settled allegations of violating a legislation towards kickbacks (2018) and charging Medicare for sufferers who had died (2017). The corporate resolved lawsuits alleging a “nationwide scheme to pay physicians kickbacks to refer their sufferers to Lincare” (2006) and that it falsified claims that its clients wanted oxygen (2001). (Lincare admitted wrongdoing in solely the 2 most up-to-date settlements.)

Such a litany of Medicare-related misconduct may be anticipated to impress drastic motion from the Division of Well being and Human Providers, which oversees the federal medical insurance program that covers 1 in 6 Individuals. Given that the majority of Lincare’s estimated $2.4 billion in annual revenues are paid by Medicare, HHS wields large energy over the corporate.

Certain sufficient, as a part of the 2023 settlement, HHS positioned Lincare on the company’s equal of probation, a so-called company integrity settlement. The foreboding-sounding doc features a “dying penalty” provision: Any “materials breach” of the probation settlement, which runs for 5 years, “constitutes an impartial foundation for Lincare’s exclusion from participation within the Federal well being care packages.” Such a ban may successfully kill Lincare’s enterprise.

That sounds dire. Besides that earlier than that company integrity settlement was signed in 2023, Lincare was below the identical type of probation, with the identical dying penalty provision, from 2018 to 2023, and violated its phrases. From 2006 to 2011, Lincare was equally on probation and in addition violated the phrases, in keeping with the federal government. And earlier than that — properly, you get the image. Lincare has been on probation 4 occasions since 2001. And regardless of a sample not solely of fraud, however of breaking its probation agreements, Lincare has by no means been required to do greater than pay settlements that quantity to pennies relative to its income.

This isn’t an aberration. Whereas HHS routinely imposes the dying penalty on small operations, it has by no means barred a nationwide Medicare provider like Lincare from persevering with to do enterprise with the federal government. Some corporations, it appears, are too huge to ban.

Lincare’s prolonged file of misbehavior isn’t a shock to individuals within the medical tools enterprise. What is shocking is the federal authorities’s willingness to tug its punches with an organization that has fleeced taxpayers and aged clients many times.

Federal officers have by no means pursued the corporate executives who oversee this habits despite the fact that two of them, Chief Working Officer Greg McCarthy and Chief Compliance Officer Jenna Pedersen, have labored at Lincare via all 4 of the corporate’s probationary durations. Nobody has confronted felony costs for exercise the federal government’s personal investigators deemed fraud.

Medicare has continued to pay Lincare billions whilst lots of the firm’s clients revile it. Evaluations on customer-review web sites are lacerating, and complaints to state attorneys basic abound. On the Higher Enterprise Bureau’s web site, 888 reviewers gave Lincare a median rating of 1.3 out of 5. They cite soiled and damaged tools, costs that proceed even after tools has been returned, harassing gross sales and assortment calls, and nightmarish customer support. As one particular person wrote in April, Lincare is “operating a rip-off the place they’ve assured earnings” and “the client can’t do a factor.”

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HHS has all the time been reluctant to chop off huge suppliers. Medicare’s first goal is to ensure nothing interrupts the move of medicines, gadgets and companies to beneficiaries. And have been HHS to hunt to ban Lincare, the corporate would absolutely launch an extended, pricey authorized conflict. However even when the price of such fight reached many tens of millions of {dollars}, it might nonetheless be a tiny fraction of the quantity misplaced to fraud, which is yet one more contributor to the hovering medical prices that bedevil the nation. “That is taxpayer cash,” mentioned Jerry Martin, a former U.S. lawyer who represented an ex-Lincare government in a whistleblower go well with towards the corporate. “We have to pay people who don’t have 4 corporate-integrity agreements.”

Weak enforcement just isn’t the one drawback. Lincare is paid to lease oxygen tools to sufferers, with HHS protecting a lot of the month-to-month payments. However these rental charges usually add as much as many occasions what it might value merely to purchase the tools. “If this have been a rational nation,” Bruce Vladeck, who ran Medicare from 1993 to 1997, instructed ProPublica, “the federal government would purchase one million [oxygen] concentrators and pay Amazon or any individual to ship them.”

In a seven-month investigation, ProPublica examined how Medicare’s largest supplier of house medical tools has managed to benefit from its clients for 1 / 4 of a century whereas heading off significant enforcement. ProPublica interviewed greater than 60 present and former staff and executives, Medicare and Justice Division officers, affected person advocates, and well being care specialists. ProPublica additionally reviewed dozens of courtroom circumstances involving Lincare and 1000’s of pages of inside firm paperwork, gross sales displays and emails.

The investigation reveals a dismal image of an organization with a gross sales tradition that depends upon squeezing infirm and aged sufferers and the federal government for each penny. Lincare staff are pressured to promote — whether or not a buyer wants a product or not — on ache of shedding their jobs.

And the corporate’s file of misbehavior and battle extends far past its gross sales and billing practices. Lincare has paid $9.5 million in settlements for information breaches and mishandling affected person and worker data. It has confronted claims of violating wage guidelines, harassing clients with gross sales and assortment calls, and tolerating racist feedback to an African American worker. (Lincare misplaced the latter go well with at trial and is interesting.) The corporate has repeatedly sparred in courtroom with former executives, together with a 2017 go well with by which longtime government Sharon Ford claimed that the corporate had cheated her out of a $1 million bonus. (A decide dominated in favor of Ford at trial earlier than the case was overturned on enchantment.) Ford testified that Lincare had earned an business fame as “The Evil Empire.” And when Lincare’s CEO, Crispin Teufel, resigned final 12 months to grow to be CEO of a rival firm, Lincare sued him for breach of contract and misappropriating commerce secrets and techniques. Teufel in the end admitted to downloading confidential firm data and was blocked from taking the brand new job. (Teufel didn’t reply to requests for remark. His alternative, Jeff Barnhard, took over as Lincare’s CEO in July 2023.)

Lincare declined a number of requests to make executives obtainable for interviews. After ProPublica offered a prolonged doc itemizing each assertion on this article, together with separate such letters to executives McCarthy and Pedersen, the corporate responded with a three-paragraph assertion. It asserted that Lincare is “dedicated to delivering high-quality and clinically acceptable tools, provides, and companies” however acknowledged “missteps prior to now.” The corporate mentioned its “new management” had “commenced a complete evaluation of our insurance policies and procedures to assist guarantee we’re complying absolutely with all state and federal rules” and that “investments and enhancements we have now made during the last a number of months will assist stop these points from repeating sooner or later.” Lincare didn’t reply to follow-up questions requesting examples of the steps the corporate says it’s taking, together with whether or not it has terminated any executives as a part of this push.

When ProPublica requested a prime Medicare enforcer why Lincare had eluded banishment, her reply prompt she views probation as a seamless ed class somewhat than a harsh punishment. “It’s like taking a school course,” mentioned Tamara Forys, who’s answerable for administrative and civil treatments for HHS’ Workplace of Inspector Normal. “On the finish of the day, it’s actually as much as you to alter your company tradition and to check, to study to cross the category … to embrace that and take these classes realized and transfer them ahead.” A spokesperson for the Facilities for Medicare and Medicaid Providers, which runs Medicare, declined to touch upon Lincare however mentioned the company “is dedicated to stopping fraud and defending individuals with Medicare from falling sufferer to fraud.”

There’s little incentive to chorus from misbehaving in an surroundings that tolerates unhealthy habits, mentioned Lewis Morris, who was chief counsel to HHS’ Workplace of Inspector Normal from 2002 to 2012. “So long as that [settlement] test is lower than the quantity you stole, it’s a great enterprise proposition.”

Certainly, Lincare has counted on the federal government’s tepid response, two former firm executives instructed ProPublica. High administration, they mentioned, responds to fraud warnings by conducting a cost-benefit evaluation. “I’ve sat in conferences the place they mentioned, ‘We would have $5 to $10 million danger — if caught,’” mentioned Owen Kirk Staggs, who ran considered one of Lincare’s companies in 2017 and fell out with the corporate. “‘However we’ve made $50 million. So let’s go for it. The danger is definitely worth the reward.’”

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Libby, Montana, offers a glimpse of the best way Lincare operates. Oxygen is an pressing want on this mountain city of two,857. Libby suffers from the lingering results of “the worst case of commercial poisoning of an entire group in American historical past,” within the phrases of the Environmental Safety Company. An open-pit vermiculite mine, which operated from 1963 to 1990, coated the realm — and residents’ lungs — with needle-like asbestos fibers. Greater than 2,000 Libby residents have been identified with respiratory ailments since then; some 700 have died.

A whole bunch of ailing residents relied on Lincare for house concentrators, which give practically pure oxygen extracted from room air. Medicare and Medicare Benefit plans (which the federal government additionally funds) lined 80% of the month-to-month rental of about $135; sufferers paid the remaining 20%.

In 2020, Brandon Haugen seen one thing suspicious in Lincare’s payments. Haugen was a customer support consultant on the firm’s native distribution website, considered one of 700 such places across the nation. (Lincare serves 1.8 million respiratory sufferers in 48 states.)

Lincare was allowed to cost sufferers and their insurers for a most of 36 months below federal guidelines. After that time, sufferers may use the tools with out additional cost. Lincare, nonetheless, saved billing native sufferers and their Medicare Benefit plans far past 36 months — in some circumstances, for years. To Haugen, this appeared like fraud.

Haugen conferred with heart supervisor Ben Montgomery. The 2, who had grown up within the space, had been buddies since seventh grade, after attending to know one another at summer time Bible camp. Then 38, earnest and simply starting to grey out of their boyishness, the 2 males have been involved. The sufferers the lads handled have been their neighbors.

A regional Lincare supervisor assured them that charging past 36 months for Medicare Benefit sufferers “is the proper solution to invoice.” Skeptical, Montgomery raised the problem with Lincare’s headquarters in Clearwater, Florida. Lincare’s compliance director instructed him, in keeping with Montgomery, that “it’s the sufferers’ drawback to repair it if they need it to cease”; that was “simply the way it labored.” Additional questions, despatched to Lincare’s chief compliance officer, Pedersen, went nowhere. “It appeared fairly apparent they have been properly conscious of this,” Montgomery instructed ProPublica. “For me, these have been my clients that you just have been screwing over.”

Amongst them was Neil Bauer, now 80, who lives in a ramshackle home “out within the boondocks,” as he put it, 38 miles southeast of Libby. Bauer spent his profession as a barber, head of investigations for the county sheriff’s division and a member of the native college board. He’s been on oxygen for greater than a decade and rapidly will get in need of breath. “I can’t do stuff a lot now,” he mentioned. His spouse is on oxygen, too. “We simply have a sick household,” Bauer mentioned.

How Lincare Billed Over $16,000 for a Respiration Machine that Prices $799

Neil Bauer wanted an oxygen concentrator to deal with asbestosis. Reasonably than shopping for one — which prices about $799 in the present day — Medicare Benefit rented one from Lincare and paid 80% of the month-to-month costs. Bauer lined the remaining 20%. Firms can invoice for a most of 36 months, after which sufferers are entitled to make use of the tools with out additional cost.

A house oxygen concentrator prices $799.

Lincare charged Bauer $27.35 a month for 36 months.

The corporate charged Medicare $109.40 a month for 36 months.

Then, violating Medicare guidelines, Lincare charged Bauer $27.35 a month for a further 85 months.

Once more violating Medicare guidelines, the corporate charged Medicare $109.40 a month for a further 85 months.

In complete, Lincare billed greater than $16,547* for a machine that value $799.

Lincare had saved billing Bauer for his concentrator for seven years after it was imagined to cease. The month-to-month copays weren’t large, however they added as much as $2,325 that he shouldn’t have been charged over that interval, a frightening sum for Bauer, who lives on a hard and fast earnings — and a hefty mark-up over the price of the tools, which could be bought on-line for $799. For its half, Medicare Benefit paid Lincare $9,299 for Bauer’s concentrator throughout this era, together with one other $5,760 for the months Lincare was legally permitted to invoice. All instructed, the rental funds to Lincare, throughout licensed and unauthorized durations, have been $16,547 for that one $799 piece of apparatus. “We paid ceaselessly,” mentioned Bauer. “By no means was I instructed that we may have one with out having to pay something.”

Haugen and Montgomery studied billing data. Among the many clients of their tiny workplace, Lincare was improperly charging no less than 33 individuals and their Medicare plans. The 2 started to surprise how far this drawback prolonged. An worker in Idaho confirmed the identical observe was occurring there. “In my thoughts,” Montgomery mentioned, “I went, ‘That is Libby, Montana. Multiply that by each heart within the nation. That is clearly rather a lot greater deal.’”

Montgomery and Haugen had seen sufficient. On Jan. 18, 2021, they emailed a joint resignation letter to Lincare’s prime administration, recounting their issues about billing that “doubtless impacts 1000’s of sufferers firm broad.” Citing the shortage of response from company officers, they wrote, “we will solely conclude that it is a recognized difficulty that’s being lined up by Lincare.”

Haugen had 10 kids. Montgomery had 4. Neither man had one other job lined up. “Had this not occurred,” mentioned Montgomery, who had been on the firm for 13 years, “I’d have seen myself retiring from Lincare.”

As an alternative, they grew to become whistleblowers. They retained a legislation agency and sued Lincare in Spokane, Washington, the positioning of Lincare’s regional headquarters. After federal prosecutors determined to again the case, Lincare settled in August 2023. The corporate admitted to overbilling Medicare plans and sufferers throughout the nation for years and paid $29 million to settle the matter, with $5.7 million of that going to Montgomery, Haugen and their attorneys. Dan Fruchter, the assistant U.S. lawyer main the federal government’s case, instructed ProPublica that the overbillings doubtless concerned “tens of 1000’s” of sufferers.

Lincare agreed to its fourth stint of probation with HHS; the brand new corporate-integrity settlement took impact on the day after the earlier one expired. The conduct Montgomery and Haugen flagged had gone on for years whereas the corporate was already on probation. However Lincare acquired the federal government attorneys to agree that no one would attempt to impose the Medicare dying penalty. Lincare asserted within the settlement that it had put in software program (which it did solely after studying of the federal government investigation) that may stop billing past 36 months. Lincare promised to make sure “full and well timed” compliance with the settlement and stop future wrongdoing.

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Medicare fraud, together with within the “sturdy medical tools” class that Lincare operates in, has lengthy been an intractable drawback. It value the U.S. Treasury an estimated $60 billion in 2023 alone.

The federal government deploys giant sums to attempt to cease it. HHS’ inspector basic’s workplace has a $432 million price range and a employees of 1,600. These assets are successfully prolonged by whistleblowers — a lot of the circumstances towards Lincare have been such fits — who can obtain a share of a civil settlement in the event that they reveal wrongdoing, and by federal prosecutors, who may also carry circumstances or be a part of these filed by whistleblowers. Final 12 months HHS recovered $3.2 billion from fraudulent schemes.

However the company’s enforcers have wielded their largest deterrent virtually solely towards small perpetrators. In 2023, they banned 2,112 small companies and people from Medicare reimbursement.

HHS hasn’t completed the identical with corporations that function on a nationwide scale. Forys, the company enforcer, mentioned she worries that expelling an enormous supplier from Medicare may go away clients within the lurch. In April, Inspector Normal Christi Grimm defended her workplace’s work in congressional testimony but additionally asserted that its assets are insufficient. An absence of employees retains it from even investigating “between 300 and 400 viable felony and civil well being care circumstances” yearly, she testified, in addition to greater than half the fraud referrals from Medicare’s exterior audit contractors.

A distinct purpose for going simple on huge corporations was prompt by Vladeck, the previous Medicare chief. In search of to bar a big provider for repeatedly violating probation would require exhaustive documentation and years of litigation towards squadrons of well-paid company attorneys. Consequently, Vladeck mentioned, “there’s an actual incentive, from a bureaucratic perspective, to only slap their wrist, give them a kick and make them apologize. … It’s a value of doing enterprise.”

There are steps enforcers may take, however virtually by no means do, that will make corporations take discover, in keeping with Jacob Elberg, a former federal prosecutor who’s now a professor at Seton Corridor Regulation Faculty. (Amongst his publications is a 2021 legislation evaluation article titled “Well being Care Fraud Means By no means Having to Say You’re Sorry.”) Elberg’s analysis exhibits that HHS and prosecutors have a tendency to barter far smaller civil settlements than the legislation permits, and so they hardly ever prosecute firm executives. Additionally they virtually by no means take circumstances to trial. In brief, enforcers have lengthy signaled to corporations that they’re in search of a clean path to a money cost somewhat than a stern punishment for a corporation and its leaders. “It’s typically a protected assumption,” Elberg mentioned, “that the end result might be a civil settlement at an quantity that’s tolerable.”

For its half, Congress might quickly be weighing a brand new legislation that will reshape how the oxygen business is paid by Medicare. However somewhat than clamp down on companies, the laws appears poised to do the alternative. A brand new invoice referred to as the SOAR (Supplemental Oxygen Entry Reform) Act would hand corporations like Lincare tons of of tens of millions extra, by elevating reimbursement charges and eliminating aggressive bidding amongst tools suppliers. Advocates say the laws will assist sufferers by making some types of oxygen extra obtainable and enhancing service. However alongside the best way it’s going to reward Lincare and its rivals.

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Congress has a historical past of treating oxygen corporations generously. For years, lawmakers set Medicare reimbursements for oxygen tools at ranges that even HHS, in 1997, characterised as “grossly extreme.” Over the succeeding decade and a half, Lincare took benefit, snatching up tons of of small suppliers and turning into the business’s largest participant.

In 2006, below strain to cut back prices, Congress authorised steps to curb oxygen funds, together with the introduction of aggressive bidding and the 36-month cap on funds for tools leases. However even these strictures have been watered down after the business poured cash into political contributions and lobbyists, who warned that cuts would hurt aged sufferers.

Lincare compensated by amping up methods that generated income, with little obvious regard for Medicare’s guidelines, which say it’s going to reimburse prices for tools solely when there’s proof of “medical necessity.” The corporate aggressively courted medical doctors and incentivized gross sales, via bonuses the corporate paid for every new machine “setup.” In response to a 2016 fee schedule, reps may earn $40 for successful an order for a brand new sleep apnea machine, $100 for a brand new oxygen affected person and $200 for a noninvasive ventilator. The whole employees of every Lincare heart may obtain a small bonus for signing up a excessive share of latest sufferers for automated month-to-month billing. Sufferers who refused auto-billing, an organization doc suggested, ought to be warned they may face “assortment exercise” and repair cutoffs. “Gross sales is our prime precedence!” declared a 2020 PowerPoint to coach new hires.

As soon as it had a buyer, Lincare would pitch them extra pricey services. A method Lincare did this was via a program referred to as CareChecks. Promoted as a “affected person monitoring” profit, CareChecks have been aimed, in keeping with an organization presentation, at producing “inside development.” If a affected person exhibited a persistent phlegmy cough, Lincare may persuade their physician to prescribe a particular vibrating vest to loosen chest mucus. Nebulizer sufferers may be candidates for house oxygen. Sufferers utilizing apnea gadgets have been potential candidates for ventilators. “We’d make sufferers suppose we have been coming in clinically to evaluate them,” a former Lincare supervisor mentioned, “when actually it was to become profitable off of them.”

Promoting alternative elements may be profitable. At Lincare name facilities that offered gadgets like hoses, masks and filters for CPAP machines (used to deal with apnea), tons of of commissioned brokers in Nashville, Tennessee, and Tampa, Florida, have been outfitted with packages displaying what gadgets every affected person was eligible for below Medicare. By legislation, sufferers needed to request alternative elements. However regularly, that wasn’t what occurred, in keeping with Staggs, who oversaw the CPAP enterprise in 2017. He found that prime salespeople, whose bonuses may complete $8,000 a month, averaged just some minutes on the telephone per order. That wasn’t practically sufficient time to establish what gadgets, if any, clients really wanted. Staggs listened to recorded calls and located that, after reaching clients, brokers usually positioned them on maintain till they hung up, then ordered them each product that Medicare would cowl.

At Lincare, outcomes have been carefully tracked and extensively shared in weekly emails displaying the perfect and worst performers in every area. Notes taken by one supervisor present supervisors’ efficiency calls for throughout weekly convention calls: “Unacceptable to overlook purpose … cease the reasons … If this isn’t being completed, unsuitable [center manager] in place … If you happen to’re not getting O2 and never getting Care Checks — you shit the mattress. Cease accepting mediocre, lazy responses ….”

“If we didn’t meet our quota, they have been going to cut our heads,” mentioned former Illinois gross sales rep Sandra Gauch, who labored for Lincare for 17 years earlier than becoming a member of a whistleblower go well with and quitting in 2022.

One salesperson was so afraid of lacking her quota, in keeping with Gauch, that she signed her mom up for a ventilator that she didn’t want. An organization audit in 2018 discovered that solely 10 of 56 ventilator sufferers at one heart have been utilizing them constantly. Some sufferers hadn’t used their gadgets for years. But Lincare saved billing Medicare.

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Just one factor mattered as a lot as maximizing new tools leases, in keeping with former staff and firm paperwork: minimizing clients’ makes an attempt to finish leases. A name to retrieve respiratory tools meant that it was not wished or getting used, and Lincare was imagined to retrieve it and promptly cease billing Medicare and the affected person. The particular person’s well being might need improved. They could have gone into the hospital — or died. The explanation didn’t matter; at Lincare, “pickups” have been a black mark, deducted from staff’ efficiency scores, jeopardizing their bonuses and jobs.

Consequently, staff mentioned, such requests have been dreaded, delayed and deterred. Scientific employees have been despatched to “reeducate” clients to maintain utilizing their gadgets. Sufferers have been instructed they’d have to signal a kind stating they have been performing “towards medical recommendation.”

Lincare managers made it clear that pickups ought to be discouraged. In a 2010 e-mail, an Ohio heart supervisor instructed subordinates: “As we have now already mentioned, completely no pick-ups/inactivation’s are to be do[ne] till I provide the inexperienced mild. Even when they’re deceased.” In 2018, an Illinois supervisor emailed her deputies that pickups have been barred with out her express approval: “Not even Loss of life that I don’t approve first.”

In February 2022, Justin Linafelter, an space supervisor in Denver, responded to the most recent company e-mail celebrating month-to-month “Achievement Rankings” for oxygen gross sales by stating that just about all the facilities atop the rankings had no less than 150 “pending pickups,” clients who weren’t utilizing their tools however whom the corporate appeared to nonetheless be billing. “A few of these facilities are simply ignoring pickups to make this record.”

That was solely considered one of Linafelter’s issues. In July of that 12 months, he emailed headquarters, saying he not had “the assets to achieve success at my job.” The customer support employees in Denver had been reduce in half, Linafelter defined, and he’d been barred from hiring replacements. Denver’s remaining employees was “at some extent of exhaustion,” threatening affected person care.

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The morning after Linafelter expressed issues to Lincare in 2022, he was summoned to a convention name with the pinnacle of HR and fired, for what he was instructed was a “company restructuring.” Linafelter, who had labored at Lincare for 9 years, mentioned, “I acquired thrown away like a chunk of trash.”

Different former staff supply comparable accounts. In 2020, Jillian Watkins, a middle supervisor in Huntington, West Virginia, repeatedly alerted supervisors that Lincare was improperly billing for tools that sufferers weren’t utilizing. Lincare blocked her from firing a subordinate who’d falsified paperwork supporting the costs, then fired Watkins, citing “insufficient route and management.”

Then got here a collection of turns. Pedersen, the chief compliance officer, successfully confirmed Watkins’ assertions, belatedly alerting the federal government about $486,000 in improper billings by Lincare. However Pedersen blamed the billings on Watkins, writing to Medicare that the corporate had “terminated” her to “stop [the problem] from recurring.” After Watkins sued, Pedersen admitted in a deposition that Watkins’ firing “had nothing to do with the overpayment.” In April 2024, a federal decide dominated that Watkins had introduced “a prima facie case of retaliation.” The go well with was privately settled in mediation.

Staggs, too, was ousted, he mentioned, after he warned prime Lincare executives about improper practices on the CPAP name facilities. Staggs emailed a Lincare HR officer: “Sufferers are being shipped provides that they by no means have ordered. … That is fraud and I’ve gotten zero help or consideration to this matter after I elevate the problem to my management.” Solely months after beginning, he was fired in November 2017. He later filed a whistleblower go well with; Lincare denied wrongdoing. After the U.S. lawyer’s workplace in Nashville declined to affix the case in 2022, Staggs withdrew the motion.

Staggs’ account of improper billings matches an business sample that seems to proceed to today. In a 2018 report, HHS’ inspector basic estimated that Medicare had paid greater than $631 million in improper claims for CPAP and different provides over a two-year interval. One other HHS evaluation recognized a further $566 million in potential overpayments for apnea gadgets.

The company’s oversight “was not ample to make sure that suppliers complied with Medicare necessities,” the 2018 report concluded. Six years later, HHS has not taken public motion towards Lincare regarding CPAPs.

At the moment, fraudulent billing amongst Medicare tools suppliers stays a “main concern,” in keeping with the inspector basic. The company says it continues to evaluation the problem.