The U.S. Department of Justice (DOJ) published a news release on February 19, 2019 concerning a whistleblower lawsuit the federal government opted to take on in which they accused Arriva Medical and parent company Alere Inc. of Medicare fraud and abuse.

According to this announcement, these companies submitted false claims for diabetic testing supply equipment that was purportedly unnecessarily provided for elderly patients. Additionally, the defendants allegedly offered to waive co-payments and offer free glucometers to seniors, committing Medicare fraud and abuse through the use of a kickback.

Arriva offered diabetic testing supplies by mail out of its headquarters in Coral Springs, Fla. Alere, a purveyor of medical devices based out of Waltham, Mass., acquired the mail order company sometime in 2011.

Medicare Fraud Discovery

In September 2017, after the Medicare fraud and abuse ostensibly occurred, Abbott Laboratories bought out Arriva and Alere. This was allegedly done despite the revocation of Arriva’s Medicare billing number done in December 2016.

According to the DOJ, Arriva had allegedly sent medical equipment to a Medicare patient half of a month past the date of their death, resulting in the levying of this consequence by the Centers for Medicaid and Medicare Services. A little over a year after the revocation in December 2017, Arriva ceased its operations.

According to Home Medical Equipment News in November 2017, Arriva was unable to get its Medicare billing rights restored after appealing this decision early in 2017. The article says that Arriva’s billing number was revoked after turning in over 200 allegedly false claims for decedents on Medicare between April 15-25, 2016.

As indicated in the DOJ press release, Arriva would ‘require’ new customers to obtain one of their new glucometers whether or not they had in their possession a perfectly adequate and functioning device.

New customers were repeatedly called and told they needed items that they offered. One Better Business Bureau complaint reads: “This company has been contacting our patients and telling them they need knee braces, back braces, wrist braces, diabetic supply. … They will call back and keep faxing until they get a threat that you will report them. Told them what they were doing was illegal and they stated that we had sent in a ‘Arriva Medical for/Prescription’. This is unbelievable. We do NOT have these forms, nor will we ever do business this way.”

Whistleblower Lawsuits

Whistleblower lawsuits filed under the federal False Claims Act (FCA) grant private citizens the right to file lawsuits on behalf of the U.S. government against contractors which might be engaging in Medicaid and Medicare fraud and abuse.

The most common type of Medicare fraud involves the submittal of false claims for payment from the U.S. government healthcare program. The government takes allegations of healthcare fraud quite seriously, as the program is supported by U.S. taxpayers, and settlements run into the millions of dollars.

The government can review evidence and decide if the case brought forth is worthy enough to join. If funds are recovered through the effort, the relator or original citizen often receives a significant percentage of the proceeds under the qui tam provision.  Whistleblowers are protected from retaliation as well.