The United States has filed a civil lawsuit against Central Medical Systems, LLC (CMS) and Alan Trent Harley alleging that they had falsely billed Medicare for wound care supplies during a six-year period. The complaint alleges that CMS and its owner, Harley, violated the federal False Claims Act by seeking and receiving inflated Medicare payments for more expensive products than had been provided to patients or for products that were never sent.
According to the government's allegations, multiple former employees reported that Harley routinely changed quantities of items while billing and manipulated orders in CMS's billing software. The government's suit also alleges that CMS billed Medicare for thousands more products than it had purchased.
The lawsuit was filed under the qui tam provisions of the False Claims Act, which permits private parties to sue on behalf of the United States for false claims for government funds and to receive a share of any recovery. Jael Cancel, the office manager of CMS, filed the whistleblower lawsuit in 2014. The Act also allows the government to intervene or take over the lawsuit, as it has done in this case, and to recover treble damages plus civil penalties ranging from $5,500 to $11,000 for each false claim the defendants submitted.
The claims asserted against CMS and Harley are allegations only, and there has been no determination of liability.
"The U.S. Attorney's Office in Orlando continues to be focused on healthcare fraud prosecutions nationwide and in Orlando, in particular. This case - against a medical supplier - shows the enforcement environment that healthcare providers are operating in. Healthcare providers, whether they be physicians or medical suppliers, would be well-served by reviewing healthcare regulations and compliance manuals," suggested former Assistant U.S. Attorney Jason Mehta of Bradley Arant Boult Cummings with an office in Tampa.
This case was investigated by the Department of Justice and the U.S. Department of Health and Human Services - Office of Inspector General. It is being prosecuted by Assistant United States Attorney Jeremy Bloor.
Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).