Information and Alerts

Government Actions 1

United States Attorney for the Eastern District of Washington vs. Lincare Holdings, Inc.

The following describes a government action that has been resolved by either a settlement or a decision by a court or administrative agency. If the matter is being appealed, it will be noted below.

On August 10, 2023 Lincare Holdings, Inc. entered into a settlement agreement with the United States Attorney for the Eastern District of Washington to resolve allegations that it fraudulently overbilled Medicare and Medicare Advantage Plans for oxygen equipment [Case No: 2:21-cv-151-TOR (E.D. Wash.)]. Per the settlement agreement, Lincare Holdings, Inc. has agreed to pay $29 million and perform extensive corrective actions.

In the settlement, Lincare admitted that it improperly billed Medicare, MA Plans, and beneficiaries for oxygen equipment rental payments and co-payments after it had already received 3 years of payments. Lincare admitted that it lacked adequate controls to ensure that MA Plans and beneficiaries were not improperly billed after 3 years of rental payments had already been received.  Lincare additionally admitted that for traditional Medicare recipients, it had controls in place to prevent improper billing, but that those controls were not always effective.  Finally, Lincare admitted that when Lincare employees raised concerns about Lincare’s billing practices, Lincare officials instructed them that Lincare would continue its billing practices.  

As part of the settlement, Lincare has paid $1.15 million to Washington State’s Medicaid program. Lincare also entered into a 5-year Agreement. That Agreement requires that Lincare implement a robust compliance and reporting program as well as a number of significant billing reforms and practices.  Additionally, the Agreement requires that Lincare retain independent experts to review its claims and billing practices to ensure they are appropriate.

Government Actions 2

United States Attorney for the Southern District of New York vs. Lincare Holdings, Inc.

On February 14, 2024 Lincare Holdings, Inc., entered into a settlement agreement with the United States Attorney for the Southern District of New York to resolve allegations that it frequently failed to visit NIV patients every sixty days, on certain occasions Lincare granted coinsurance payment waivers that were inaccurate  [Case No: 1:18-CV-00783-PGE] Filed in the US District Court, Southern District of New York. Per the settlement agreement, Lincare Holdings, Inc. has agreed to pay a total sum of $25.5 million, of which $24 million will be paid to the United States and the remainder will be paid to various states. For one of the state's settlements, The State of Florida, $150,000 was paid back to Florida Medicaid.

Lincare admitted that they knew patients needed to use their NIVs to receive the benefits of NIV therapy, and frequently failed to visit NIV patients every 60 days to confirm that the patients were using their NIVs. Lincare continued to seek monthly payments from Federal healthcare programs for NIV rentals even when staff had not verified the usage of the NIVs.

The settlement resolves claims that Lincare violated the False Claims Act by fraudulently continuing to bill federal health care programs for the rental of costly non-invasive ventilators (“NIVs”) when patients no longer needed or used the devices. The settlement also resolves claims that Lincare violated the Anti-Kickback Statute by waiving coinsurance payments to induce certain Medicare and Tricare beneficiaries to rent NIVs.