A Jacksonville wound-care provider has agreed to pay up to $22.51 million in fines to settle federal charges that it fraudulently billed Medicare for medically-unnecessary treatments.
Per Justice Department investigators, Healogics, Inc. submitted false claims to Medicare from 2010 through 2015 relating to hyperbaric oxygen (HBO) therapy, a service that it provides regularly at almost 700 wound-care centers throughout the country.
Investigators say Healogics ordered scores of treatments for individuals in cases where the procedure was either unnecessary or unreasonable. The procedure is ordinarily covered by Medicare and involves exposing a patient’s entire body to pure oxygen at higher-than-ordinary atmospheric pressure.
Along with the payment of fines, Healogics has agreed to enter into a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General. The program will include independent claims reviews and systems reviews to be carried out for the duration of the program.
The charges were the result of lawsuits brought by four separate individuals, including two doctors, a former Healogics director, and a former project director, under the qui tam (whistleblower) provision of the False Claims Act (a/k/a the “Lincoln Law”), which the Justice Department pursued after investigating the allegations.
Per the terms of the agreement, Healogics will pay $17.5 million in fines up front, plus up to an additional $5.01 million should specified financial events with the company manifest over the next 5 years.