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October 20, 2011

Medical equipment provider settles with government

Complaint alleged unlicensed technicians used in Indiana

JEFFERSONVILLE — The U.S. Attorney and Indiana Attorney General have reached an agreement with a Louisville company accused of using unlicensed personnel to set up medical equipment in Southern Indiana homes.

Premier Home Care agreed to pay $578,820 to the United States and $21,180 to Indiana, U.S. Attorney for the Southern District of Indiana Joseph Hogsett said at a press conference Wednesday.

The company, which has been in business since 1997, has eight offices — one in Scottsburg and seven in Kentucky, including Louisville. They provide medical equipment in Southern Indiana and Central and Southeastern Kentucky.

“[Premier] was accused of falsely certifying that licensed technicians had provided, installed or set up continuous positive airway pressure respiratory machines,” Hogsett said.

In 2008, a former Premier employee filed a sealed complaint, or a “whistleblower” lawsuit, in U.S. District Court in New Albany. Another complaint was filed in Clark County Superior Court No. 2.

The complaint alleged Premier violated the False Claims Act by falsely certifying it was in compliance with state licensure requirements, while it actually used unlicensed personnel to set up continuous positive air pressure and bi-level positive airway pressure respiratory machines.

The complaint further alleged Premier’s claims for payment to Medicare and Medicaid were false because the services were rendered by unqualified personnel. The Indiana Board of Respiratory Care issues licenses, according to the U.S. Attorney’s Office. A company cannot bill for equipment unless it is using licensed technicians.

Hogsett said there were times that licensed personnel would sign for the installation, but unlicensed personnel would actually install the equipment. He believes the company struggled to keep employees who were licensed in Indiana.

“There was no evidence of that any machines malfunctioned nor were there any reports of patient injuries,” Hogsett said.

Wayne Knewasser, vice president of public relations and government affairs for Premier, released a statement that the government agreed to settle because they were unsure they could prove their case.

“The recent press release from the Southern District of Indiana Department of Justice unfairly attempts to deliver the impression that fraud was committed, proven and/or admitted. Nothing can be further from the truth,” the company’s statement reads. “Our commitment to ethical business and billing practices has allowed us to become one of the region’s foremost home medical equipment providers.”

The estimated total loss to Medicare and Medicaid programs was $254,658. Premier agreed to settle for nearly twice that amount in order to resolve the case. The company did not admit to liability, which Hogsett said is common in civil proceedings. Hogsett said the company is now in compliance with state regulations, and one reason they decided not to file criminal charges is because they cooperated and immediately took steps to rectify the problems.

Hogsett said several hundred patients in Indiana were involved. They reviewed the company’s practices from mid-2004 until the end of 2008.

Supervising Deputy Attorney General Steve Hunt touted the cooperation between state agencies and the courage of the whistleblower, Michael Kaiser. The Indiana “whistleblower law” rewards people who report fraud on a government agency. They are entitled to between 15 percent and 25 percent of the government’s recovery.

Kaiser received about $108,000 from the total settlement

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