Crown Medical Solutions Pays $825K to Settle DME Fraud Allegations

LEMON GROVE, California—Crown Medical Solutions LLC and its owners, Michelle King and Philanzo King, have agreed to pay $825,000 to resolve allegations that Crown and its owners violated the False Claims Act by submitting false claims for payment to Medicare.

Crown was a supplier of durable medical equipment (DME), such as knee braces, heel stabilizers and back braces. The United States alleged that, from Nov. 1, 2017 through April 30, 2019, Crown and its owners billed Medicare for DME provided to Medicare beneficiaries that was not medically necessary or not properly prescribed by a physician. The settlement is based on defendants’ ability to pay.

“The Department of Justice is committed to fighting healthcare fraud and holding accountable those who exploit federal healthcare programs for personal profit,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division.

The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Karen Martinelli. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned United States ex rel. Martinelli v. Crown Medical Solutions, LLC, et al., No. 1:19-cv-01660 (N.D. Ga.). As part of this resolution, Martinelli will receive approximately $123,750 of the settlement amount.