A settlement has been reached to resolve False Claims Act allegations against Pacific Pulmonary Services.
The allegations arose from a lawsuit that claimed Pacific Pulmonary Services filed false reimbursement claims with federal health care programs and arranged a kickback scheme with sleep-testing clinics.
According to the Department of Justice, Pacific Pulmonary Services has since about 2004 submitted claims for reimbursement to Medicare, Tricare and federal employee health benefits programs for home oxygen and related equipment without physicians’ approval, as required by program rules.
Also, in 2006, certain of the company’s patient care coordinators also allegedly agreed to make patient referrals to sleep testing clinics in exchange for those clinics’ agreement to refer patients to Pacific Pulmonary Services for sleep therapy equipment.
Reportedly, Pacific Pulmonary Services is the business name of Braden Partners LP and Teijin Pharma USA LLC. Pacific Pulmonary Services provides oxygen tanks, related supplies and sleep therapy equipment.
“This settlement demonstrates our tenacity in pursuing health care providers who seek to take advantage of federal healthcare programs,” said Acting Assistant Attorney General Readler. “Providers who cut corners and pay kickbacks should be aware that they may face serious consequences.”
A former Pacific Pulmonary sales representative, Manuel Alcaine, will receive $1.824 million, or about 16 percent of the settlement. Mr. Alcaine sued the company in 2010 under the whistleblower provisions of the False Claims Act, which allows private citizens who expose fraud against the government to share in any recovery.
