The agreement results in a country where data protection breaches in the health sector are scrutiny more closely by federal and regional authorities. Healthcare companies are also in the legal heat, as hacker groups continue to exploit long-standing vulnerabilities. One of Lincare`s biggest competitors in the home acid sector is Apria. Humana, a health insurance company, runs various state-funded Medicare Advantage health insurance plans. Thomas claimed that Humana had negotiated with Apria to accept lower payments under the Humanas Medicare Advantage plans for home oxygen equipment and accessories than the rates calculated by Lincare Humanas Medicare Advantage for similar DMEs. Aprias` authorization to accept such reduced reimbursements from Humana had the effect of reducing the costs incurred by the federal government to fund these Medicare Advantage acidivage benefits and also led beneficiaries of Humana`s Medicare Advantage plans to pay lower supplements when they received their equipment and oxygen supplies at home from Apria and not from Lincare. Mr. Thomas asserted that lincare, in order to avoid losing market share in Apria`s capital with respect to the Medicare Advantage plans managed by Humana, partially waived the supplements it charged to domestic acidity customers covered by the Medicare benefit plans managed by Humana to essentially obtain the supplements they would pay, if they received their acidity from Apria. However, Lincare continued to receive higher reimbursements than Apria received from publicly funded Medicare benefit plans for this type of DME.
Lord. Thomas claimed that the reduction of these supplements, in order to influence customers` decisions to purchase or pay for their devices and oxygen stores at home in Lincare and not apria, was contrary to the federal anti-kickback law that made Lincare`s entries illegal for payments from Medicare advantification plans managed by Humana for such DMEs under the False Claims Act. The allegations were first brought to light in 2015 in a complaint filed by Brian Thomas, a former billing director at Lincare. The False Claims Act allows individuals to take legal action on behalf of the government for false allegations and participate in a possible claim….