In brief: Lincare settles allegations, OM posts increase, ONeal Medical drops DME

NEW YORK – Lincare will pay $25.5 million to resolve claims that it violated the False Claims Act by fraudulently continuing to bill federal health care programs for the rental of non-invasive ventilators that patients no longer needed or used.   

The settlement also resolves claims that Lincare violated the Anti-Kickback Statute by waiving coinsurance payments to induce certain Medicare and Tricare beneficiaries to rent NIVs. 

As part of the settlement, Lincare also made factual admissions regarding its conduct. The company admitted that it received reimbursement from federal health care programs for some NIV rental claims that did not comply with all of those programs’ billing rules and guidance. It also admitted that in some instances, it continued to seek monthly payments when it was aware that patients were not using the devices. 

“When DME suppliers like Lincare knowingly seek federal funds for items that are not medically necessary and not being used, they threaten the sustainability and financial integrity of vital federal health care programs like Medicare and Medicaid,” said Damian Williams, U.S. Attorney for the Southern District of New York. “Companies will be held accountable for fraudulent billing practices that prioritize profits over legal obligations.” 

As part of the settlement, Lincare admitted and accepted responsibility for certain conduct alleged by the United States, including the following: 

In violation of internal protocols, Lincare’s center clinical staff frequently failed to visit NIV patients every 60 days to confirm that the patients were using their NIVs as directed by their physicians.  Some centers lacked sufficient staff to adequately monitor patient progress and confirm that patients were using the devices as directed by their physicians.  On many occasions, clinical staff did not perform home visits for NIV patients for several months. 

In addition to conducting patient visits, Lincare had the ability to remotely monitor certain patients’ NIV usage for certain newer NIV models through online cloud-based platforms. However, Lincare did not use these systems to confirm that those patients were using the devices as directed.  

OM’s Patient Direct posts 8% increase 

RICHMOND, Va. – Owens & Minor reported fourth quarter revenue of $664 million for its Patient Direct segment, up 8% compared to the fourth quarter of 2022. 

Consolidated revenue was $2.7 billion, an increase of 4%. 

“We once again delivered on our commitments and had a strong finish to 2023, demonstrated by our top-line growth across both business segments, robust profit growth and exceptional operating cash flow which allowed us to further strengthen our balance sheet,” said Edward A. Pesicka, president & CEO. “Our Patient Direct segment continued to outperform the market, showcasing the ongoing effectiveness of our go-to-market strategies on top of the healthy demand for home-based care." 

The company issued its outlook for 2024, including:  

• Revenue for 2024 to be in a range of $10.5 billion to $10.9 billion 
• Adjusted EBITDA for 2024 to be in a range of $550 million to $590 million. 

EnsoData receives clearance for AI-powered sleep diagnosis 

MADISON, Wis. – EnsoData has received FDA 510(k) clearance from the Food and Drug Administration for AI-driven analysis of PPG signals (EnsoSleep PPG) which supports the diagnosis of sleep disorders using any FDA-cleared pulse oximeter. EnsoSleep, EnsoData's previously FDA-cleared diagnostic AI analysis and sleep scoring solution, uses machine learning to analyze data from traditional sleep studies to aid physicians in diagnosing sleep disorders. With this new clearance, EnsoSleep PPG will provide more opportunities for clinicians to effectively reach an undiagnosed patient population by enabling AI-driven analysis using the photoplethysmogram (PPG) signals recorded by pulse oximeters. “Expanding EnsoData’s capability to collect and analyze PPG signals from simple, wearable pulse ox devices will accelerate the identification, diagnosis and treatment of sleep disordered breathing events, including sleep apnea,” said Justin Mortara, president and CEO of EnsoData. “With this latest FDA clearance, we expect to build upon and diversify our partner ecosystem to reach more patients with our leading AI solutions.” By lowering the barrier for patients to receive an accurate sleep test to more widely available pulse ox devices, clinicians can expedite the diagnostic process and provide patients with answers to their health problems more quickly, says EnsoData. 

Listen to Justin Mortara talk about using AI to make health care better 

ATF Medical promotes Carter 

NEWNAN, Georgia — ATF Medical, a national provider of complex rehabilitation equipment and home modifications in workers’ compensation, has promoted Grace Carter to senior vice president of finance & operations, where she oversees the company’s finance and operations team, including human resources and information technology and manages security, privacy, and accreditation. She joined ATF Medical over 10 years ago, and most recently served as executive director of operations & finance.  “Grace has helped us develop the systems and policies needed to support the company’s growth,” said Susan Nelson, co-founder and COO. “We are so proud to have her on our executive team.” Carter’s career spans banking, real estate finance and law, customer service, and financial and revenue accounting. Prior to ATF Medical, she worked for Washington Post Media as manager of credit & contracts.  

WellSky Foundation makes $200K donation to fight food insecurity 

OVERLAND PARK, Kan. – The WellSky Foundation, a nonprofit dedicated to removing socioeconomic barriers to health and improving the quality of life for vulnerable populations, today announced a donation of $200,000 to Pete’s Garden. Founded in 2020, the organization recovers wholesome surplus prepared and perishable food from local businesses, repackages the food into family-sized meal portions, and distributes the free take-home meals to food-insecure families through various social service organizations. With the donation from the WellSky Foundation, Pete's Garden will be able to expand its Kids Feeding Kids program, a curriculum aiming to provide a real-world learning module to educate students on the causes of food insecurity while developing their culinary skills. “This grant will support scaling up our Kids Feeding Kids program, which recently launched a successful pilot program with a gift from the 15 and Mahomies Foundation,” said Tamara Weber, founder and executive director of Pete’s Garden. “By the end of the WellSky Foundation’s two-year grant period, we expect over 100 teachers to be trained across Kansas and Missouri, extending the program's reach and impact to thousands of high school students who will plan and prepare tens of thousands of meals for families in their communities.” 

 DocGo adds senior leadership 

NEW YORK – DocGo Inc., a provider of technology-enabled mobile health services, has announced the addition of two senior leaders bringing significant experience in large-scale public health program management and value-based care partnerships with health plans. Yong Kim has joined as vice president of Health Plan Partnerships from his most recent role leading business operations and strategy for CVS Health’s population health and care management programs. Jen McLean has joined as vice president of Government and Public Health Programs from her most recent role as Chief Operating Officer of City Harvest in New York City. “We are seeing significant momentum right now from both health plans and governments to realize the potential of virtual and deployable mobile care solutions to deliver positive, measurable results in patient health and overall savings in total costs of care,” said Lee Bienstock, CEO of DocGo. “We believe both Jen and Yong will be crucial and beneficial to expanding our programs with these core customer groups and will greatly support our mission of democratizing access to healthcare through innovative and efficient technology.” Kim will be responsible for health plan partnerships, business growth strategy for future collaborations and value-based care programs. McLean will work with dedicated city, government and community-based organizations on mobile service solutions to help solve emergent and continuing population health needs. DocGo’s virtual, deployable care delivery model serves governments and health plans by providing healthcare, behavioral health and related support to people wherever they are outside of the walls of traditional health care facilities. 

Medline employees gather large food drive donation 

NORTHFIELD, Ill. – Medline collected more than 9,000 pounds of donations during ag food across 25 branches. Food insecurity affects nearly 13% of the U.S. population, according to the U.S. Department of Agriculture. That percentage grew between 2021 and 2022, and it’s substantially higher when focused on Black and Hispanic households. In observance of Black History Month, Medline is highlighting its commitment to addressing food insecurity through volunteer engagement. Medline’s Black Employee Network (BEN), an employee resource group, organized members and allies around the country to host food drives that kicked off on Martin Luther King Jr. Day. “It was about us coming together, honoring Dr. King and showing how we can take action in our own communities,” said Carol Barnett, BEN co-chair and director of business planning and operations. The food drive was a collaboration with the Environmental, Social and Governance team. 

ONeal Medical phases out DME to focus on respiratory 

PELHAM, Ala. – ONeal Medical will stop filling durable medical equipment orders for new patients after March 31, 2024, as it focuses on home respiratory, including oxygen and sleep therapy. The provider will continue to service its existing DME patients and will accept DME orders for new patients if the order includes oxygen or sleep therapy equipment. “As a home owned and operated business, we continue to be deeply committed to our local community, and support many local charitable organizations. Our home oxygen service remains very much at our core, and we are excited to bring a new level of patient care, new innovations, and products to CPAP patients across the area,” said the company. ONeal Medical has locations in Pelham and Birmingham, Ala., including CPAP Plus, which it launched in 2021.