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 received improper payments from the Vermont Medicaid Program.
Keene Medical Products, Inc. is a durable medical equipment supplier that offers numerous services, medical devices, and medical supplies to patients. The settlement resolves an investigation examining whether Keene filed improper claims related to oximetry equipment (measuring blood oxygen saturations) and supplies, and other medical supplies. An investigation identified that Keene’s claims to Medicaid for oximetry probes were improper because Keene also billed for rental of the oximeter. Medicaid rules required that supplies necessary to the operation of rented equipment, such as oximetry probes, be included in the rental rate and prohibits separate billing for the necessary supply. The investigation also determined that Keene had overbilled Medicaid for sterile water used in the treatment of Medicaid beneficiaries receiving respiratory services.
Under thesettlement agreement, Keene will repay $451,621.09 to the Vermont Medicaid program and also pay $10,000.00 in additional recoveries to the State. Pursuant to the settlement agreement, Keene has also entered into a Corporate Integrity Agreement with the State of Vermont that will require enhanced compliance activities for up to three years. TheCorporate Integrity Agreementincludes provisions requiring an independent review of Keene’s claims for the prior two years, and up to three years following the execution of the agreement. Keene will be required to return to Vermont Medicaid any overpayment identified by those reviews and must also establish a compliance program designed to prevent or limit future false claims. Copies of the Settlement Agreement and the Corporate Integrity Agreement are available via the links below. The Medicaid Fraud and Residential Abuse Unit was assisted by the Program Integrity Unit of the Department of Vermont Health Access in obtaining this settlement.
Vermont AG: Feb 9, 2016