Facts

SuperCare Health Inc., is a Downey, California based provider of respiratory services and durable medical equipment. It provides non-invasive ventilators (NIVs), for home use by respiratory patients in California and Nevada. Medicare and Medicaid provided a monthly reimbursement for a patient's rental of an NIV, so long as it is necessary or reasonable for the patient's treatment. Relator Benjamin Martinez, Jr. filed a qui tam action against SuperCare alleging that SuperCare violated false claims laws by billing Medicare, Medicaid, other government programs, and private insurance companies for the rental of NIVs that are neither medically necessary nor actually used by patients.

PLAINTIFFS' CONTENTIONS: Plaintiffs contended that from May 2013 through October 2013, defendant submitted or caused to be submitted fraudulent claims for payment to Medicare and Medicaid seeking reimbursement for NIV rentals. More specifically, plaintiffs contended defendant billed public health programs when the NIVs were not medically necessary or reasonable due to the lack of continued use or need by the beneficiaries located in California and Nevada.

DEFENDANT'S CONTENTIONS: Defendant denied all of the contentions.

Result

The case settled for $3,310,000.