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In addition to the $4 million cash payment, the San Antonio wheelchair supplier
will give up the right to reimbursement for most of its pending Medicare claims.
Such claims total more than $43 million, but Medicare estimates that the payments
The SCOOTER Store could actually expect to have received based on those claims
is approximately $13 million. Medicare commonly reimburses less than the face
value of claims presented to the agency for payment.
The settlement resolves a lawsuit brought by the United States in 2005, in which the
government alleged that The SCOOTER Store engaged in a multi-media advertising
campaign to entice beneficiaries to obtain power scooters paid for by Medicare,
Medicaid, and other insurers. Instead of the “zippy” power scooters that were
advertised, The SCOOTER Store sold the beneficiaries expensive power wheelchairs
that they did not want, need, and/or could not use.
The SCOOTER Store received $5,000 to $7,000 in reimbursement for each power
wheelchair it sold, more than twice the amount for a scooter, which sold for around
$1,500 to $2,000. Many beneficiaries had no idea what kind of equipment they were
getting, until it was delivered by The SCOOTER Store.
The government’s lawsuit also alleged that The SCOOTER Store knowingly sold
used power mobility equipment to beneficiaries and billed Medicare as if the
equipment were new, in violation of Medicare regulations. In addition, the U.S.
alleged that The SCOOTER Store charged Medicare millions for unnecessary power
mobility accessories.
New rules for power mobility implemented last year by the Department of Health
and Human Services Centers for Medicare and Medicaid Services are designed in
part to prevent the abuses that resulted in the government’s lawsuit against The
SCOOTER Store. In addition, The SCOOTER Store will operate for the next five
years under a Corporate Integrity Agreement with the Office of the Inspector
General at the Department of Health and Human Services that is designed to help
ensure future compliance by the company with Medicare regulations.
The civil settlement resolves several lawsuits filed by The SCOOTER Store against
the United States seeking payment for its claims to Medicare. As part of the
settlement, The SCOOTER Store gave up those claims and agreed to dismiss the
lawsuits.
The civil settlement also resolves claims in a suit brought by a whistleblower who
was a former employee of The SCOOTER Store. As a result of the settlement, the
whistleblower will receive $3,228,251 as the statutory award, and the
whistleblowers’ suit also will be dismissed. Under the qui tam provisions of the
False Claims Act, private parties can file an action on behalf of the United States
and receive a portion of the settlement if the government reaches a monetary
agreement with the defendants.
The case was investigated by the FBI’s San Antonio Health Care Fraud Unit, the
Texas Attorney General’s Medicaid Fraud Control Unit, and the Office of the
Inspector General, Department of Health and Human Services and was handled by
the U.S. Attorney’s Office for the Western District of Texas and the Civil Division
of the Department of Justice.
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