North Atlantic Medical Services: Unlicensed Staff at the Patient’s Door

In the North Atlantic Medical Services settlement, Regional Home Care agreed to pay $852,378 to resolve allegations that it billed Medicare and Medicaid for respiratory care performed by unlicensed employees. The government alleged that workers entered patients’ homes to set up sleep apnea masks and oxygen equipment, and the company billed as though licensed personnel had performed the services. For someone who knew the staffing, the home visits or the billing, the question was concrete: who actually provided the care behind the claim?

Regional Home Care, Inc., doing business as North Atlantic Medical Services, was a durable medical equipment supplier based in Leominster, Massachusetts. It provided equipment and services for oxygen deficiency and sleep apnea. The Justice Department announced the settlement on December 1, 2014. Its allegations covered September 2010 through January 2013.

Massachusetts was to receive $229,210 of the settlement because it had paid part of the Medicaid claims.

The Staffing Savings Behind the Claims

The whistleblowers’ complaint alleged that North Atlantic Medical Services saved money by substituting lower-paid, unlicensed employees for licensed personnel while collecting equipment reimbursement that assumed professional services. The complaint called the company NAMS and put the labor costs beside each other:

The complaint’s accusation was that the company took its saving out of the licensed care the payment assumed. A supplier paying for qualified respiratory staff carried a labor cost that North Atlantic Medical Services allegedly avoided. Patients were supposed to receive that health care, and taxpayers were paying for it.

What the Unlicensed Employees Allegedly Did

The complaint described unlicensed liaisons setting up equipment, initiating therapy and teaching patients to use it after one month of training. That month allegedly consisted of two weeks in the office with another liaison and two weeks on the road with liaisons and respiratory therapists. The workers were then expected to do the work independently.

For oxygen patients, the whistleblowers alleged that unlicensed oxygen technicians performed the initial setup and instruction. The complaint said a respiratory therapist should have followed up within 24 to 48 hours, but that those visits never occurred. It also alleged that unlicensed liaisons performed pulse-dose evaluations, which the complaint described as clinical respiratory services requiring licensed personnel.

The equipment could arrive at the address while the licensed respiratory care allegedly went missing.

The complaint also described oxygen quantities being entered from a technician’s estimate of how heavy a container felt. The complaint said the container should have been weighed before and after filling. The alleged delivery record carried a guess instead of a measurement.

Warnings and Unsigned Visit Records

The government alleged that North Atlantic Medical Services continued using unlicensed personnel after the Massachusetts Department of Public Health told the company the practice was illegal. Even after that warning, the company allegedly kept billing Medicare and Medicaid as though licensed personnel had provided the services.

The complaint separately alleged that the company’s accrediting organization told it to stop using unlicensed personnel for respiratory care. According to the whistleblowers, the company continued using liaisons and omitted the oxygen follow-up visits. The whistleblowers described instructions to leave the visitor’s signature off the record:

The complaint alleged that a supervisor subsequently signed that paperwork. A later signature cannot put its signer in the patient’s home. The allegation points to a gap between the person who performed the service and the person whose name appeared on the visit record.

What Evidence Is Needed to Report Medicare Fraud?

For respiratory-care allegations like these, the useful evidence connects the employee’s qualifications, the service actually performed and the resulting claim. We work through those connections with you, bringing your knowledge of the visits, payroll and billing together to build the whistleblower case.

Why a Respiratory License Matters to the Claim

State licensing requirements reach into the Medicare supplier rules. The federal supplier standards require the appropriate license where a state requires one to furnish an item or service. They also address using a licensed individual or entity to provide licensed services where state law permits that arrangement.

In its settlement announcement, the Justice Department explained that Massachusetts required respiratory therapists to meet professional licensing requirements. It described an associate’s degree in respiratory therapy, or its equivalent, followed by a licensing examination administered by the National Board for Respiratory Care. The government’s allegation connected that qualification directly to payment: North Atlantic Medical Services billed for services as though licensed personnel had performed them.

The state Medicaid stake also reaches beyond this case. The HHS Office of Inspector General’s Medicaid Fraud Control Units Fiscal Year 2023 Annual Report, published in 2024, found that medical device manufacturers and durable medical equipment suppliers were the provider types associated with the most civil settlements and judgments that year. Its findings put equipment suppliers squarely within state Medicaid enforcement.

What Other Respiratory Cases Show

Other respiratory cases show how staff qualifications and home visits expose problems behind equipment billing. Areté Sleep resolved allegations about sleep tests performed by technicians who lacked required licenses. That case concerned the diagnostic testing step. North Atlantic Medical Services’ case concerned the respiratory care provided when equipment reached the patient.

In the Oxygen Plus complaint, a respiratory therapist alleged seeing ventilators sitting unused during home visits while the company continued billing Medicare and Kentucky Medicaid. The person visiting the patient could see something the continuing claims did not disclose. In the North Atlantic Medical Services case, the alleged discrepancy was who delivered the care and whether the follow-up happened at all.

The North Atlantic Medical Services whistleblowers put staffing costs, respiratory work, warnings and signatures into the same account of the business. That is the value of an insider’s view: knowing how the service was performed and how the paperwork came to describe it. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Know Who Made the Visit

If you know who performed the respiratory care and who signed for it, talk with our whistleblower experts about the claims behind those visits. We build the case with you and bring in healthcare whistleblower lawyers who understand respiratory-service billing and staff qualifications. We stay beside you as your knowledge of the operation becomes the foundation of the case.