Fraudulent Air

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Cropped shot of a handsome mature male doctor using a tablet while standing in the hospital corridor

According to the Mayo Clinic, hyperbaric oxygen therapy (HBOT) is used to treat decompression sickness, a hazard of scuba diving. It can also be used to treat serious infections, air bubbles in veins and arteries, and wounds that won’t heal. The owner of a Maryland-based hyperbaric business is the focus of today’s fraud article because he paid more than $400,000 to settle allegations of healthcare fraud.

While the hyperbaric company, which has multiple locations in Maryland, was not found guilty of healthcare fraud, their billing practices were suspicious. According to the settlement agreement, for more than 20 months the former president and part-owner prepared bills that stated care provided was supervised by a physician. That was a lie because apparently, no qualified professional was involved with any patient’s treatment. (Let’s take this moment to list a couple of things that can go wrong with HBOT such as lung damage, bursting of the middle ear, sinus damage, vision changes and oxygen poisoning. Uh, that’s really scary.)

In addition to the incorrect claims, the former president also allowed inaccurate claims to be submitted to TRICARE, the health insurance program for the military. Then, he authorized the submission of medical care documents for TRICARE patients so they could be approved for continued treatment. (Here’s the problem – that medical information was misleading. It turns out that the treatments were either medically unnecessary or never provided.)

Two former employees brought the shady billing practices to the attention of the government by filing a lawsuit against the HBOT company. (The lawsuit claimed that false claims were submitted for therapy services that weren’t needed, properly supervised or actually provided.)

The former president and part-owner of the HBOT company agreed to pay $414,640.25 to settle the false claims allegations. The two former employees of the company who blew the whistle, will receive $74,635.25 from the settlement. (See, it really pays to tell the truth.)

It’s important to remember that this settlement is not an admission of guilt regarding healthcare fraud.  Fortunately, the company is now under new ownership and the former president is no longer employed. (The government and the company’s patients can now breathe a little easier.)

Today’s “Fraud of the Day” is based on an article, “HyperHeal to pay over $400,000 for unnecessary hyperbaric oxygen therapy,” posted on WUSA9.com on May 30, 2019.

MARYLAND, USA — HyperHeal Hyperbarics, a hyperbaric oxygen therapy facility, has agreed to pay over $400,000 to settle false claims allegations.

HyperHeal agreed to pay $414,640.25 to settle the claims that the facility submitted false claims to the U.S. for physician services that weren’t rendered, and for “medically unnecessary hyperbaric oxygen therapy,” a press release said.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.