Charlotte-based BSN Medical has agreed to resolve allegations that it marketed and promoted various products that did not meet the Medicare or Medicaid program’s reasonable and necessary requirements, thereby causing the submission of false claims for payment to the healthcare programs, according to Dena J. King, U.S. Attorney for the Western District of North Carolina.
BSN, which specializes in compression therapy, wound care, and orthopedics, has agreed to pay $785,672.14 to resolve the allegations.
The settlement resolves allegations that from Jan. 1, 2015 through Dec. 31, 2017, BSN marketed and promoted various products that were not reimbursable because BSN had either not obtained approval from the Medicare Pricing, Data Analysis and Coding (PDAC) contractor, or for which PDAC approval had expired, in connection with three Healthcare Common Procedural Coding System (HCPCS) Codes, specifically, E2607, L0625 and L0626.
The allegations arose from a lawsuit filed by a whistleblower under the qui tam provisions of the federal False Claims Act and multiple state false claims act statutes. Under the federal False Claims Acts, private citizens can bring suit on behalf of the government for false claims and share in any recovery. The act also allows the government to intervene and take over the action. The government conducted the investigation and intervened in this action to effectuate the settlement.
The settlement is a result of the coordinated effort between the Department of Health and Human Services Office of the Inspector General, a National Association of Medicaid Fraud Control Units (NAMFCU) Team, which included representatives from the Offices of Attorneys General from the states of North Carolina and Indiana, and the United States Attorney’s Office for the Western District of North Carolina.
The lawsuit resolved by this settlement is United States et al. ex rel. Bruce Carroll v. BSN Medical, Inc., et al. (3:17-CV-480), filed in the Western District of North Carolina. The claims resolved in this settlement are allegations only and there has been no determination of liability.
Tamala Miles, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) for the region including North Carolina, joined U.S. Attorney King in making this announcement.