Business ProfileforGrapevine Professional Services, Inc.

As of February 14, 2022

Medicare reimbursement consultant Ted Albin and his wholly-owned consulting and billing firm Grapevine Billing and Consulting Services Inc. (Grapevine), both based in Stuart, Florida, have agreed to pay $50,000 to resolve allegations that they violated the False Claims Act. This settlement resolves allegations that Albin and Grapevine caused the submission of false claims to Medicare because of kickbacks to Medicare beneficiaries and because patients were ineligible to receive glucometers. This settlement is based on the United States’ analysis of financial disclosures made by Grapevine.

In its complaint, the United States alleged that, from 2008 until 2017, Albin and Grapevine provided consulting services to now-defunct diabetic testing supplier Arriva Medical LLC (Arriva), its parent Alere Inc. (Alere), and starting in January 2018, Abbott Laboratories (Abbott), after Abbott acquired Arriva and Alere in October 2017. From at least 2009 until 2011, Albin, through Grapevine, allegedly served effectively as the Head of Reimbursement at Arriva, overseeing Arriva’s reimbursement department, developing Arriva’s policies for the collection of beneficiary copayment obligations and submitting claims to Medicare on Arriva’s behalf for diabetic testing supplies.

The United States alleged that, as consultants to Arriva, from April 2010 until the end of 2016, Albin and Grapevine knowingly caused the submission of claims to Medicare that were tainted by the payment of kickbacks to Medicare beneficiaries in the form of (i) free or “no cost” glucometers, or (ii) the routine waiver of beneficiary copayment obligations. Additionally, the United States alleged that Albin and Grapevine knowingly caused the submission of claims to Medicare for glucometers on behalf of beneficiaries who were not eligible to seek reimbursement because they had received a meter paid for by Medicare within the previous five years.

The United States produced sworn testimony from Albin in the litigation in which he admitted that, as a reimbursement consultant for Arriva, Albin personally (1) would “write off customer co-payments” because “I could tell someone on my team ‘Yes, write this off,’” (2) engaged in such write-offs “probably every week,” (3) engaged in “mass write-offs of denials by Medicare” for ineligible meters, (4) created Arriva’s “routine policy not to send a bill for customers who owed less than $5,” and (5) “came up with the policy” of “courtesy adjustments” in the form of copayment waivers in response to customer complaints about their Medicare coinsurance obligations.

The litigation resolved by this settlement originally included claims against Arriva and Alere that were brought under the qui tam or whistleblower provisions of the False Claims Act by Gregory Goodman, a former employee in Arriva’s Antioch, Tennessee call center. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The act also permits the United States to intervene and take over the litigation of a qui tam action, as the United States did here.  In August 2021, Arriva and Alere agreed to pay $160 million to resolve the claims against them. The United States also previously settled for $1 million claims against Arriva’s founders, David Wallace and Timothy Stocksdale, for their alleged part in the scheme. The litigation, which is concluded by the settlement announced today, is currently captioned United States v. Albin, et al., Case No. 3:13-cv-00760 (M.D. Tenn.).

LINK: https://www.justice.gov/opa/pr/florida-based-medicare-reimbursement-consultant-resolves-litigation-allegedly-causing-false