J&L Medical Services LLC, a medical equipment provider with locations throughout Connecticut including Fairfield, has agreed to pay $600,000 in a settlement agreement to resolve allegations it violated the federal and state False Claims Acts by using unlicensed technicians to provide respiratory therapy services.
According to U.S. Attorney Deirdre M. Daly, J&L regularly utilized the services of unlicensed technicians to provide respiratory therapy services to Medicare and Medicaid beneficiaries, including setting up continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) machines, fitting the patients, who had been diagnosed with sleep apnea, with the masks used with those machines and educating the patients about the use of the machines.
In a statement, J&L company co-founder and President John Loyer, emphasized that the company was not asked to admit any wrongdoing.
“We think it”™s important for our patients and the members of the medical community to understand that the government never claimed J&L Medical Services failed to deliver quality care or equipment,” Loyer said. “This was a matter of our disagreeing with their interpretation of Connecticut law about who can work with sleep apnea patients to do the initial set up of their CPAP machines.”
Loyer stated that the company was following largely common medical practices by using patient-care technicians, including licensed practical nurses, emergency medical technicians, respiratory students or others trained and supervised by licensed respiratory therapists.
“When the government first came to us in 2013 with their interpretation of the licensing law, which was contrary to ours, we explained our disagreement but also our willingness to find a way to resolve that disagreement,” Loyer said. “Ultimately, we have agreed to refund to the government a portion of the funds paid for equipment delivered to our CPAP patients. In addition, J&L Medical Services has changed its practices to correspond with the government”™s interpretation of the law. Since 2013, J&L Medical Services has only used licensed respiratory therapists to set up CPAPs and that will continue to be our practice.”
To resolve the allegations under the federal and state False Claims Acts, J&L agreed to pay $600,000, which covers Jan. 1, 2008 through May 15, 2013.
As part of the settlement, J&L also agreed to implement a compliance program intended to prevent and/or detect fraud, waste and abuse in claims submitted by the company to the Connecticut Medicaid program.
A complaint against J&L was filed in U.S. District Court in Connecticut under whistleblower provisions of the both the federal and state False Claims Act. The whistleblower, John Hart, a former employee of J&L and a licensed respiratory therapist, will receive a share of the proceeds of the settlement in the amount of $102,000.
The whistleblower provisions of both the federal and state False Claims Act provide that the whistleblower is entitled to receive a percentage of the proceeds of any judgment or settlement recovered by the government.
People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at 203-777-6311.
