As a result of a joint investigation with Florida’s Medicaid Fraud Control Unit (MFCU), other state MFCUs and the U.S. Department of Justice, Apria Healthcare Group. Inc. and Apria Healthcare LLC reached a settlement in a Medicaid fraud case and will pay a total of $40 million, of which $4,812,000 will go toward reimbursing state Medicaid programs.
Florida’s share of the nationwide recovery is approximately half a million dollars.
There are more than 300 Apria branch offices across the nation, including Florida. According to the federal-state investigation, Apria submitted false claims to state Medicaid programs for the ongoing rental of non-invasive ventilators (NIV) that Medicaid beneficiaries either did not use or medical professionals deemed not medically necessary.
Attorney General Ashley Moody said, “We will not allow bad actors to falsify forms or blatantly bill Florida taxpayers for services never rendered or not medically necessary. I am proud of the role my Medicaid Fraud Control Unit played in investigating this multimillion-dollar fraudulent billing scheme inflicted on taxpayers in Florida and across our country, and the recovery of more than $40 million.”
The investigation arose from an action filed in the United States District Court for the Southern District of New York in 2017 under the federal False Claims Act (FCA) and various state false claims statutes. The settlement resolved allegations that, from Jan. 1, 2014 through Dec. 31, 2019, Apria violated the FCA by submitting false claims to state Medicaid programs to seek reimbursement for NIV rentals when the NIVs were not medically necessary or reasonable due to the lack of continued use or continued need by the beneficiaries; or when certain NIV models that were only to be used in certain situations, were not medically necessary or reasonable.