The settlement resolves allegations of AdaptHealth, formerly known as QMES and Tri-County Medical Equipment and Supply, billing payers for noninvasive ventilators “when a patient was instead prescribed and used a BiPAP machine — for which federal payers reimburse suppliers thousands of dollars less per year,” the Justice Department said in a news release.
The case also accused AdaptHealth of billing insurance companies for ventilators after patients stopped using them and of double-billing payers for ventilator rental between 2013 and 2017.
A former QMES employee filed the whistleblower lawsuit and will receive about $950,000.
AdaptHealth did not claim liability.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.