A Lehigh Valley breast pump and maternity product provider will pay $1 million to settle federal allegations of false reimbursement claims.
Scottie Girl LLC, doing business as The Breastfeeding Shop with a location at 431 Chestnut St. in Emmaus, and owner Patty Gatter will pay the money as a part of a settlement agreement with the United States, according to a Dec. 1 news release from U.S. Attorney David Metcalf of the Eastern District of Pennsylvania.
According to the U.S. Attorney’s Office, the agreement resolves allegations that The Breastfeeding Shop submitted false claims for reimbursement for breast pumps and related equipment for beneficiaries of TRICARE, the health care program managed by the Defense Health Agency for U.S. military members, retirees and their families.
The government accused the business of billing TRICARE hundreds of dollars more per breast pump than it charged to the state’s Medicaid program as well as billing TRICARE separately for breast pump accessories that were included in the standard kit.
“Fraud involving TRICARE, the healthcare system for military members and their families, is something we take seriously and will investigate fully,” Christopher Silvestro, acting special agent in charge of the Defense Criminal Investigative Service Northeast Field Office, said in the release.
The settlement did not require the business to admit to wrongdoing, and in an interview Gatter told The Morning Call that the actions were unintentional and the result of incorrect guidance from contractors who administered the benefit when it began being offered in 2015. She said when TRICARE provided updated guidance, she complied immediately.
She said she entered into the settlement agreement because “for a small business to go up against the government is … that’s not going to be a fair situation for the small business. They have a lot more money than I do.”
The Breastfeeding Shop continues to be a provider for TRICARE, she added.
“My passion for growing my company is alive and well,” Gatter said. “And I’m an optimist by nature, and I love helping new and expecting moms. So … I take this very seriously. The fact that I went through something, for me, that was overwhelming but continue to be a valued partner helps me kind of come to terms that unfortunately, things like this are the norm in this world, even though it’s a hard lesson to learn. And rather than being afraid of it, I have to be open, honest and transparent and move forward and be helpful to the insurance companies.”
The U.S. Attorney’s Office declined to comment further on the case.