In a press release, the U.S. Department of Justice (DOJ) indicated that a Pennsylvania-based supplier, along with its former owners, paid the U.S. in excess of $4 million today to settle allegation of Medicare fraud, amounting to millions of dollars. The charges result from the principals’ filing of false claims for reimbursement.

The settlement concerned lymphedema pumps and sleeves, two pieces of medical equipment Advanced Care sells. The company is our of Fort Washington, Pennsylvania.

Two of the former owners, Robert Miller and Robert Wolk, and their wives, Anne Miller and Harriet Wolk received a lifelong ban from participating in either the Medicare program or certain state health care insurance plans.

The government contended the defendants submitted falsified

Medicare documents relating to the medical condition of Medicare beneficiaries. In this way, they obtained reimbursement from the government health insurance program for hundreds of lymphedema and sleeve pumps.

The pumps and sleeves may be used to treat lymphedema, a swelling in the arms or legs caused by the accumulation of excessive lymph fluid. According to a whistleblower complaint filed in U.S. District Court in Philadelphia, the defendants materially changed information on forms and certificates of medical necessity signed by physicians without their authorization or knowledge, evening forging their signatures.

According to government allegations, the defendants routinely told Medicare claimants that there would be no charge to them for the pump and sleeve, thus inducing them to buy the pump and assign the Medicare claim to Advanced Care, allowing them to seek millions of dollars in payments from Medicare.

The Medicare patients are typically required by law to pay a deductible and 20 percent copayment.

Another complaint says the defendants often supplied equipment to patients while submitting claims to the government that showed the equipment was new. They were also charged with destroying documents to mask their scheme.

Besides the $4 million payment, Advanced Care and its parent company, The Care Group, voluntarily enrolled in a 3-year program to ensure compliance with all Medicare and Medicaid regulations.

Have information on Medicaid Fraud?

If you have information about Medicaid fraud, contact the Medicaid Fraud Reporting Center for a confidential claim evaluation today. You may report Medicaid fraud by completing the form on this page, or by calling our Medicaid Fraud Hotline at 1-800-934-2921.