Comfort Care Medical Equipment, Inc. and one of its owners, Patrick Chalmers, have agreed to pay the United States $352,800 to resolve allegations that they violated the federal False Claims Act by submitting false claims to the Office of Personnel Management (OPM), which administers the Federal Employees Health Benefit Program (FEHBP). Comfort Care is a durable medical equipment provider that provides compression and lymphedema garments, for various body parts including legs and arms, to patients. The civil investigation was opened by the United States Attorney’s Office based upon a referral from OPM, OIG regarding excessive billings. Comfort Care billed almost all compression stockings (arms, legs, bras, etc.) utilizing HCPCS Code A6459 (gradient compression garment, not otherwise specified). According to the contract that Comfort Care had with Care First, which administered the FEHBP plan, Comfort Care could utilize this code only if no other HCPCS code could be billed for the compression garment provided. Once the A6549 HCPCS code was used, Comfort Care could bill FEHBP contracted plans for any amount and would be reimbursed at 65% of that amount.
