By Ron Maloney
If things were tough at The Scooter Store, they got more
difficult Friday.
A legal battle with the federal government heated up in a civil countersuit
filed Friday by the Department of Justice in the U.S. District Court
for the Western District of Texas in San Antonio, in which federal
attorneys allege the company submitted fraudulent claims to Medicare
and Medicaid.
The Scooter Store is one of Comal County’s largest employers.
It markets mobility scooters and power wheelchairs to the aged, disabled
and infirm with a guarantee that if the company finds a customer eligible
and then the federal government refuses to pay for the device, The
Scooter Store will pay for it.
Charles Miller, spokesman for the civil division of the U.S. Department
of Justice, said Friday the court action was a counterclaim to a complaint
filed by The Scooter Store for reimbursement for hundreds of claims
in cases where the Department of Health and Human Services disallowed
reimbursements for power wheelchairs.
The federal attorneys involved in the case would not be available,
Miller said.
“We don’t discuss litigation outside the courtroom,” he
explained.
Since 2003, when The Scooter Store complained about irregularities
in the power wheelchair business in the Houston area — kicking
off a federal probe called “Operation Wheeler Dealer” in
which physicians and other mobility purveyors in that area were convicted
for fraudulent claims — The Scooter Store itself has been target
of an FBI investigation.
CEO Doug Harrison announced the investigation and threw the company’s
doors — and books — open to federal investigators.
No charges have ever been filed, and the FBI in the months since has
refused to do more than acknowledge the investigation.
Miller said Friday the DoJ action was unconnected to any criminal
investigation and said he had no knowledge of whether any criminal
charges would be filed.
FBI officials in San Antonio Friday did not return calls in time for
this story.
More stringent review of eligibility for power wheelchairs and mobility
scooters snarled federal reimbursement for hundreds of scooters and
reduced sales, leading to layoffs of more than 250 employees of The
Scooter Store who were laid off in 2003 and 2004.
In a DoJ news release issued in conjunction with the court filing,
Peter D. Keisler, assistant attorney general for the department’s
Civil Division, alleged a pattern of Scooter Store employees making “misrepresentations
to Medicare beneficiaries and their doctors to obtain reimbursement
from the federal healthcare program for power wheelchairs, as opposed
to much less expensive power scooters.”
That deception revolved around allegedly false claims made to customers
that Medicare would only pay for the more expensive wheelchairs or
that physcians would not approve orders for motorized scooters.
The cost of damages allegedly sustained by the two federal programs
have not been calculated, but the DoJ release stated The Scooter Store
has billed Medicare for more than $400 million in claims since 1997.
“This lawsuit demonstrates our continued commitment to pursuing
vigorously allegations of fraud and abuse in Medicare,” Keisler
said. “Medical equipment providers can and will be held accountable
for their billing practices.”
Officials at The Scooter Store Friday said President Mike Pfister
was not available for comment on the action. In a prepared statement,
Pfister said he was not surprised.
“The United States government today filed compulsory counterclaims
against The Scooter Store’s legal case for Medicare reimbursement.
This procedural action was expected and would have been forfeited if
not taken,” Pfister said.
Pfister said the government applied inconsistent eligibility standards
and violated its own laws in denying claims.
“Unfortunately, this move by the government indicates that some
officials are more interested in second-guessing the conclusions reached
by doctors than they are in making sure that qualified Medicare beneficiaries
have access to the medical equipment their doctors say they need,” Pfister
said.
“The Scooter Store has been and will continue to be an active
and open partner with the government. The Scooter Store is committed
to ensuring that only qualified beneficiaries receive the medical equipment
they need and that the highest ethical and compliance standards are
exceeded.
