VirtuOx resolves allegations 

MIAMI – VirtuOx has agreed to pay $3.15 million to resolve allegations that it submitted or caused to be submitted false claims to Medicare for reimbursement, according to an announcement from the Department of Justice, U.S. Attorney’s Office, Southern District of Florida. 

The Coral Springs, Fla.-based company, which operates Medicare-approved Independent Diagnostic Testing Facilities (IDTFs), allegedly violated the False Claims Act by falsely identifying the place of service for certain services it performed to obtain a higher rate of reimbursement from Medicare from January 2016 to December 2020. In particular, the company allegedly knowingly submitted false claims to Medicare identifying its IDTF located in San Francisco as the location of service for overnight pulse oximetry tests when no services were performed at that location in relation to the overnight oximetry claims. 

The company allegedly also administered overnight pulse oximetry tests and, at times, also billed Medicare for single determination pulse oximetry tests – commonly referred to as an oxygen “spot check” – for the same patient when the only test performed was the overnight test. 

As part of the settlement, VirtuOx entered into a five-year Corporate Integrity Agreement with the U.S. Department of Health and Human Services, Office of Inspector General, that requires, among other things, that the company retain an outside expert to perform annual claims reviews that address the place of service identified on the claim. 

The settlement arose from a lawsuit filed by Amber Watt, who will receive $630,000 in connection with the settlement as the whistleblower. Watt was represented by Andrew Melling, a partner at Burr Forman, based in Columbia, S.C. 

VirtuOx provided the following statement when contacted by HME News: 

“Since 2005, VirtuOx has operated Joint Commission accredited Medicare enrolled IDTFs in California, Florida and Washington, D.C., to help treat patients across the country that suffer from respiratory, sleep and cardiac diseases. One of our competitors, Amber Watt, the owner of BREATHE Oximetry, filed a whistleblower suit against us in 2019 after we sent (the company) a demand letter regarding theft of our intellectual property. The government conducted a thorough investigation and declined to intervene in the suit. Shortly thereafter, federal judge Robert Scola Jr. dismissed BREATHE’s unfounded allegations with prejudice. Amber Watt’s attorneys appealed Judge Scola’s ruling to the 11th Circuit Court of Appeals, and the government worked with Medicare to put VirtuOx on payment suspension while the appeal played out in court. To avoid protracted and costly litigation and to get the payment suspension lifted, VirtuOx decided to settle the lawsuit without admitting any wrongdoing. We are glad to have this behind us and are excited to refocus on providing best-in-class care to our patients across the country.”