By: Christopher A. Parrella, Esq., CPC, CHC, CPCO Parrella Health Law, Boston, Ma. A Health Law Defense and Compliance Firm

A Health Law Defense and Compliance Firm

In a significant development in healthcare compliance enforcement, United Seating and Mobility, LLC, doing business as Numotion, has agreed to pay $13.5 million to resolve allegations that it submitted false claims to Medicare and other federal healthcare programs. The U.S. Attorney’s Office for the District of Arizona announced this settlement, which brings to light critical issues surrounding the evaluation and billing practices in the provision of custom wheelchairs and wheelchair parts.

The Allegations Against Numotion

The crux of the allegations was that Numotion submitted claims based on patient evaluations that were unlawfully authored, completed, or signed by its employees rather than qualified medical professionals. These actions are a direct violation of the False Claims Act (FCA), which holds companies accountable for defrauding government programs.

Custom wheelchairs and related parts are essential for patients, particularly veterans, who rely on federal healthcare programs. These devices require a thorough medical evaluation to ensure they meet the specific needs of each patient. The Department of Justice (DOJ) emphasized that medical professionals must conduct these evaluations, not sales personnel from the supplier.

The Importance of Compliance and Self-Reporting

One of the notable aspects of this case is that Numotion voluntarily disclosed several overpayments to the United States, cooperating fully with the investigation. This cooperation and self-reporting were significant factors in determining the settlement amount. The settlement agreement also resolves three whistleblower lawsuits, showcasing the vital role of whistleblowers in exposing fraudulent practices.

The DOJ’s crackdown on improper billing practices serves as a reminder that compliance with federal regulations is non-negotiable. Healthcare providers must ensure that their billing processes align with legal requirements, particularly when dealing with federal programs like Medicare and Medicaid.

Ensure Your Compliance Now

This case underscores the importance of robust compliance programs within healthcare organizations. To avoid similar pitfalls, healthcare providers should regularly audit their billing practices, ensure that all evaluations are conducted by qualified professionals, and maintain transparency with regulatory bodies.

If your organization has any concerns about its compliance practices or needs guidance on navigating federal healthcare regulations, Parrella Health Law is here to help. We specialize in healthcare law and can provide the expert advice you need to protect your organization from legal risks.

If you have any questions or comments about the subject of this blog, please contact Parrella Health Law at 857.328.0382 or Chris directly at cparrella@parrellahealthlaw.com.