MYNORTHWEST NEWS

Healthcare company pays Washington more than $1M for overbilling

Jan 13, 2025, 1:18 PM | Updated: Jan 14, 2025, 6:00 pm

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A gavel. (Photo: Joe Gratz via Flickr Creative Commons)

(Photo: Joe Gratz via Flickr Creative Commons)

A healthcare company was ordered to pay the state of Washington more than $1 million, according to a news release from the Washington State Attorney General’s (AG) Office on Monday.

The AG’s Office stated a Medicaid Fraud Control Division investigation revealed Lincare Inc., which provides oxygen tanks, overbilled its patients. Therefore, the company was ordered to pay out $1.15 million.

“This will reimburse the state’s Medicaid program for Lincare’s fraudulent overbilling of leased oxygen equipment,” the AG’s Office said.

According to the news release, Lincare is headquartered in Florida and provides in-home respiratory devices to patients throughout the U.S. It also offers services such as renting and servicing oxygen equipment to patients with respiratory conditions who rely on the equipment to breathe. The company keeps a billing office in Spokane Valley to manage Pacific Northwest operations.

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The AG’s Office noted Medicaid provides oxygen equipment on a five-year contract and, under Washington law, Medicaid pays rental fees on oxygen equipment for three years. Providers like Lincare can continue to bill for maintenance and supplies for an additional two years, but may no longer charge rental fees. The AG’s Office said after that, the device is eligible for replacement.

Washington State Attorney General Bob Ferguson asserted between January 2017 and March 2023, Lincare knowingly billed rental fees beyond the allowed three years more than 15,000 times. In some instances, Ferguson said Lincare continued to bill Medicaid rental fees for six years, twice the legal limit.

“The Attorney General’s Office Medicaid Fraud Control Division estimates Lincare overbilled Medicaid for 565 Washington patients by more than half a million dollars,” the news release stated.

However, this isn’t the first time Lincare has owed the state money. In 2023, the company entered into a $29 million resolution with U.S. Attorney for the Eastern District of Washington Vanessa Waldref. The Attorney’s Office for the Eastern District of Washington called it the “largest-ever healthcare fraud settlement in Eastern Washington.”

Waldref announced Lincare agreed to pay $29 million and “perform extensive corrective actions to resolve allegations that it fraudulently overbilled Medicare and Medicare Advantage Plans for oxygen equipment,” as stated in a news release.

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According to the AG’s Office, the 2023 resolution required the company to “significantly” change its billing practices and, at its own expense, hire independent experts to review its work. Shortly after Waldref’s resolution, the Medicaid Fraud Control Division’s investigation began.

The news release stated as part of the legal agreement, Lincare will have to comply with Washington’s oxygen leasing laws and will also ensure it has internal controls to prevent further violations.

Julia Dallas is a content editor at MyNorthwest. You can read her stories here. Follow Julia on X and email her here.

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