Dynasplint Settles False Medicare Claims for $10.3M; Whistleblower to Get $2M
Dynasplint Systems Inc. and its founder/president George Hepburn have agreed to pay $10.3 million to resolve allegations that they knowingly submitted or caused the submission of false claims to federal health care program Medicare for splints provided to patients in skilled nursing facilities, the U.S. Department of Justice announced last week.
The government alleged that Hepburn and Dynasplint knowingly mischarged Medicare for splints used by patients in Medicare-certified skilled nursing facilities. Patients staying in skilled nursing facilities, or their insurers such as Medicare, pay a bundled payment to these facilities that cover all of a patient’s needs, including such items as splints, and thus no separate Medicare reimbursement for such devices is permitted. To circumvent Medicare rules, defendants allegedly mispresented that patients were in their homes or other places that were not skilled nursing facilities.
The settlement resolves allegations originally brought in a lawsuit filed by Meredith Deane, a former sales executive for Dynasplint, under the whistleblower, or qui tam, provisions of the False Claims Act, which allow private parties to bring suit on behalf of the government and to share in any recovery. The United States may intervene in such an action as it did here. Ms. Deane will receive at least $1.98 million for the settlement.
In August 2013, the U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) suspended payments to Dynasplint based upon credible allegations of fraud. As part of the settlement, defendants are agreeing to forfeit all funds held by this payment suspension, approximately $8.5 million.
The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments. We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud. Read more about our expertise in False Claims Act cases and how you can take action.