WASHINGTON — House Republicans are demanding records from a Florida-based organ procurement center after a whistleblower alleged a possible Medicare fraud scheme involving staff members overbilling for work hours and improperly reimbursing for personal costs or other expenses.
The House Ways and Means Committee fired off a letter Thursday to the Life Alliance Organ Recovery about the purported scheme, also citing a troubling report involving a patient who had also been kicked off life support but was still “crying and biting on his breathing tube” as clinicians “waited for death.”
“One Life Alliance employee interpreted” the response “as the patient not wanting to die,” stated the letter sent by Ways and Means Chairman Jason Smith (R-Mo.) and Subcommittee on Oversight Chairman David Schweikert (R-Ariz.) to Life Alliance Organ Recovery Center executive director Clifton McClenney.
Smith called the “potential Medicare reimbursement fraud” — which may have included abuse of the organization’s tax-exempt status “to enrich board members or senior leadership” — as well as current reports on the quality of donor care at the center “deeply, deeply disturbing.”
“Among the most concerning statements are those regarding the misuse of taxpayer dollars, including that Life Alliance staff members were encouraged to increase their hours and bill Medicare for hours not worked; Life Alliance received reimbursement from Medicare for costs associated with the personal use of a company vehicle; and Life Alliance double dipped on its Medicare Cost Report (“MCR”) for certain expenses,” Smith said in the missive.
“The Committee on Ways and Means,” he added, “is concerned that if these allegations were verified, they would constitute a violation of the False Claims Act.”
The records request comes after a 2021 resolution of three lawsuits against the University of Miami, of which the center’s surgery department is a division, alleging False Claims Act violations.
Those had accused the center of “ordering medically unnecessary laboratory tests and submitting false claims for pre-transplant lab testing,” noted Smith’s letter, which was also addressed to University of Miami President Joseph Echevarria.
In 2015, Life Alliance had also been found to be a member not in good standing due to other concerns about the level of care and patient safety.
“Tax-exempt organ procurement organizations save the lives of countless Americans each year, but the success of our nation’s organ transplant network depends on these organizations maintaining the public’s trust and operating within their stated tax-exempt purpose,” the chairman said in a statement.
“The Ways and Means Committee will not rest until these organizations are held accountable and public trust is restored.”
The Republican-led panel’s inquiry follows similar investigations into organ transplant nonprofits in Indiana, Oklahoma and New Jersey, according to a report in the Free Press, which also cited possible overbilling for Medicare costs — including for the potential use of a private jet for personal trips.
That came on the heels of investigations by the Department of Health and Human Services’ Office of Inspector General finding instances of improper Medicare reimbursements.
Smith has asked Life Alliance to hand over by Aug. 14 its accounting records on Medicare costs, service contracts, financial interests, business relationships and all documents on its policies, conduct, practices and procedures that may touch on potential federal violations.
McClenney, Life Alliance and Echevarria did not immediately respond to requests for comment.
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