Crown Medical Solutions LLC (Crown) and its owners, Michelle and Philanzo King, have agreed to pay $825,000 to resolve allegations that Crown and its owners violated the False Claims Act by submitting false claims for payment to Medicare.
Crown was a supplier of durable medical equipment (DME), such as knee braces, heel stabilizers, and back braces. The United States alleged that, from Nov. 1, 2017 through April 30, 2019, Crown and its owners billed Medicare for DME provided to Medicare beneficiaries that was not medically necessary and/or not properly prescribed by a physician. The settlement is based on defendants’ ability to pay.
“The Department of Justice is committed to fighting healthcare fraud and holding accountable those who exploit federal healthcare programs for personal profit,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division.
The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Karen Martinelli. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned United States ex rel. Martinelli v. Crown Medical Solutions, LLC, et al., No. 1:19-cv-01660 (N.D. Ga.). As part of this resolution, Martinelli will receive approximately $123,750 of the settlement amount.
The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Northern District of Georgia.
The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. 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).
This year the Administration launched the Task Force to Eliminate Fraud and the National Fraud Enforcement Division to enhance the Administration’s war on fraud, waste, and abuse in federal programs. When unscrupulous actors exploit these programs for their own financial gain, they defraud the government, harm the people these programs are designed to aid and protect, and undermine American businesses that play by the rules. The Civil Division’s FCA enforcement plays a critical role in combatting such fraudulent schemes, recovering billions of dollars for the American taxpayers, and holding wrongdoers accountable. FCA matters will continue to be on the forefront of the battle against fraud, and the Civil Division’s FCA work will support and advance the mission of the Task Force to Eliminate Fraud and the National Fraud Enforcement Division.
The matter was handled by Commercial Litigation Branch Trial Attorney Anna Jugo and Assistant U.S. Attorney Neeli Ben-David for the Northern District of Georgia.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
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