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Judy Greenwald

Medical supply company to pay $1.8M to settle claims of improper Medicare billing

September 7, 2012



A Mississippi medical equipment and supply company will pay $1.8 million to settle claims it had improperly billed Medicare in a case initially brought by whistle-blowers, said the U.S. attorney's office in Birmingham, Ala., on Wednesday.

The U.S. attorney's office said that according to the settlement agreement, Southaven, Miss.-based Pinnacle Medical Solutions L.L.C. violated the False Claims Act from September 2007 through May 2009 by submitting false claims to Medicare and the Federal Employees Health Benefits Program for blood glucose monitoring strips and lancets. The claims were either for more or different supplies than Pinnacle had shipped, for more supplies than had been ordered, and/or for supplies that lacked supporting documentation.

The lawsuit against Pinnacle was filed as a whistle-blower complaint in June 2009 by two company employees. A federal investigation that preceded the lawsuit resulted in Pinnacle refunding $236,204 to Medicare in July 2009. The settlement is in addition to that amount.

James F. Barger, a partner with Frohsin & Barger L.L.C. in Birmingham — and an attorney for one of the whistle-blowers, former reimbursement specialist Wendy Horne — said in a statement that Ms. Horne first brought her allegations to the company's leadership then, after seeing little change, notified the U.S. Department of Health and Human Services.

“Wendy Horne put her career on the line to stand up for our nation's veterans and the elderly,” Mr. Barger said. Under the False Claims Act, whistle-blowers receive 15% to 25% of recoveries in cases where the government intervenes, his statement noted.

A Pinnacle spokesman could not be reached for comment.

 



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