Oxygen And Sleep Therapy Company Agrees To Resolve False Claims Act Allegations

BOSTON – Regional Home Care, Inc., (d/b/a North Atlantic Medical Services) (NAMS), a durable medical equipment supplier based in Leominster, Mass., has agreed to pay $852,378 to resolve allegations that it violated the False Claims Act by submitting claims to Medicare and Medicaid for respiratory care services provided by unlicensed personnel. NAMS provides equipment and services for the treatment of respiratory ailments, such as oxygen deficiency and sleep apnea.

“This respiratory care company flouted important licensure requirements, failed to provide patients the standard of care that they deserve, and fraudulently billed the federal government for improperly rendered services,” said U.S. Attorney Carmen M. Ortiz. “With the important assistance of whistleblowers, our health care fraud team seeks to ensure patient safety and protect the public fisc.”

“Respiratory care services should be performed by properly licensed personnel,” said Acting Assistant Attorney General Joyce R. Branda for the Justice Department’s Civil Division. “We will not tolerate companies prioritizing their own profits and convenience at the expense of patient safeguards.”

The Massachusetts Department of Public Health requires respiratory therapists to meet professional licensure requirements in order to provide respiratory care. To apply for a Massachusetts license, one must first earn an Associate’s Degree in Respiratory Therapy, or its equivalent, and then, must pass a licensure examination administered by the National Board for Respiratory Care. This settlement resolves allegations that, from September 2010 through January 2013, NAMS sent unlicensed employees into patients’ homes to set up sleep apnea masks and oxygen therapy equipment. The government alleged that, even after the Massachusetts Department of Public Health informed the company that the practice was illegal, NAMS continued to use unlicensed personnel and billed Medicare and Medicaid for these services as if they had been performed by licensed personnel.

Medicaid is jointly funded by the states and federal government. The Commonwealth of Massachusetts, which paid in part for the Medicaid claims at issue, will receive $229,210 of the settlement amount.

The case was investigated by the Department of Health and Human Services, Office of the Inspector General, and the Federal Bureau of Investigation, and was handled by District of Massachusetts Assistant United States Attorneys Giselle Joffre and George Henderson and Department of Justice Trial Attorney Benjamin Young.

The claims resolved by this settlement are allegations only; there has been no determination of liability