Two power wheelchair manufacturers will pay the U.S. government $7.5 million to settle allegations that they filed false Medicare claims.
The case involves Salt Lake City-based Orbit Medical and its spin-off, Rehab Medical, which were accused of knowingly altering physician prescriptions and supporting data so that power wheelchairs supplied by Orbit would be paid for by Medicare.
Specifically, the government alleged that Orbit sales reps changed or added dates on the records to suggest a physician saw the patient within 45 days of Medicare billing, as is required. The sales reps also allegedly changed prescriptions to make them appear to prove medical necessity and forged physician signatures on prescriptions and chart notes.
The Department of Justice announced the agreements, which include corporate integrity agreements, on May 27.
Orbit CEO Brandon Bliss tells IDDM that the 2010 incidents were the work of a few employees at one of Orbit’s 26 shops, and came amid a “perfect storm” of lowered reimbursement and increased government scrutiny.
Under the terms of the corporate integrity agreements, both companies must appoint compliance officers and compliance committees within 90 days. Oversight of the compliance committee will fall to the board of directors, which will meet quarterly to discuss the program and report on its progress to the HHS Office of Inspector General. The CIA also requires that all employees receive a written code of conduct requiring compliance with federal rules, as well as a document explaining the policies and procedures of the compliance program.
The CIAs also require the companies to hire third-party auditors to review any claims to Medicare or other government health programs. The OIG will validate the results of the audit.
Bliss says the company has already submitted some of the required compliance plan and foresees no difficulties meeting DOJ’s conditions.
The False Claims Act allegations stem from a qui tam complaint filed by two former Orbit employees. They will share a whistleblower reward of about $1.5 million.
Orbit and Rehab could not be reached for comment by press time.