Vermont Business Magazine The State of Vermont and Keene Medical Products, Inc. have reached an agreement settling a multi-year investigation by the Medicaid Fraud and Residential Abuse Unit of the Attorney General’s Office and the Program Integrity Unit of the Department of Vermont Health Access regarding whether Keene submitted false claims or received overpayments from the Vermont Medicaid Program. Keene will pay in excess of $460,000 to settle potential claims,under the Vermont False Claims Act and Vermont Medicaid Fraud Statute, that Keene receivedimproper payments from the Vermont Medicaid Program.
Keene Medical Products, Inc. is a durable medical equipment supplier that offersnumerous services, medical devices, and medical supplies to patients. The settlement resolves aninvestigation examining whether Keene filed improper claims related to oximetry equipment(measuring blood oxygen saturations) and supplies, and other medical supplies. An investigationidentified that Keene’s claims to Medicaid for oximetry probes were improper because Keenealso billed for rental of the oximeter. Medicaid rules required that supplies necessary to theoperation of rented equipment, such as oximetry probes, be included in the rental rate andprohibits separate billing for the necessary supply. The investigation also determined that Keenehad overbilled Medicaid for sterile water used in the treatment of Medicaid beneficiariesreceiving respiratory services.
Under the settlement agreement, Keene will repay $451,621.09 to the Vermont Medicaidprogram and also pay $10,000.00 in additional recoveries to the State. Pursuant to the settlementagreement, Keene has also entered into a Corporate Integrity Agreement with the State ofVermont that will require enhanced compliance activities for up to three years. The CorporateIntegrity Agreement includes provisions requiring an independent review of Keene’s claims forthe prior two years, and up to three years following the execution of the agreement. Keene willbe required to return to Vermont Medicaid any overpayment identified by those reviews andmust also establish a compliance program designed to prevent or limit future false claims.