LOS ANGELES –SuperCare Health, Inc., a Downey-based provider of home respiratory services and durable medical equipment, has agreed to pay $3,315,308 to resolve allegations that it defrauded public health care programs by billing for ventilator services that were not medically necessary or reasonable, the Justice Department announced today.
SuperCare entered into a settlement agreement with the United States and two states – California and Nevada – in a federal False Claims Act case that a federal judge unsealed today.
The allegations in this case stem from SuperCare providing non-invasive ventilators, also known as NIVs, for home use by respiratory patients in California and Nevada. Medicare and Medicaid provide a monthly reimbursement for a patient’s rental of an NIV, so long as the NIV is necessary or reasonable for the patient’s treatment.
Between May 2013 and October 2019, according to the lawsuit, SuperCare submitted, or caused others to submit, bogus claims to Medicare and Medicaid. SuperCare allegedly billed public health programs for NIV rentals even when patients no longer needed the NIVs or were no longer using them.
The settlement resolves allegations brought in a 2018 lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act by Benjamin Martinez Jr., a respiratory therapist who worked for SuperCare. These provisions permit private parties to sue on behalf of the government for false claims for government funds and to share in any recovery. Mr. Martinez will receive more than $612,000 from the federal government as his share of the settlement amount.
The U.S. Department of Health and Human Services, Office of Inspector General investigated this case.
Assistant United States Attorney Ross M. Cuff of the Civil Division’s Civil Fraud Section negotiated the settlement for the government.
The claims resolved by the settlement are allegations only; there has been no determination of liability.