Crown Medical Solutions and owners agree to $825,000 DME billing settlement
Oct 11, 2026 edition · GC-2026-0130 · Published 2026-10-11 · Version 4 · Settled
Crown Medical Solutions and its owners agreed to an ability-to-pay settlement over allegedly unnecessary or improperly prescribed DME. The $825,000 agreement resolves civil allegations, not adjudicated fraud. The case points to physician-order and medical-necessity controls rather than unrelated assessment-override practices.
What happened
DOJ’s September 21 announcement says Crown Medical Solutions and owners Michelle and Philanzo King agreed to pay $825,000 to resolve False Claims Act allegations. Crown supplied durable medical equipment, including knee braces, heel stabilizers and back braces. The government alleged that, from November 1, 2017, through April 30, 2019, the company and its owners billed Medicare for equipment that was not medically necessary, was not properly prescribed by a physician, or both. The settlement amount was based on the defendants’ ability to pay.
The resolution includes whistleblower claims brought by Karen Martinelli in a Northern District of Georgia case; DOJ reported that she would receive approximately $123,750 of the settlement. The release expressly states that the resolved claims are allegations and that liability was not determined. It therefore does not establish an admission of fraud or completed receipt of the settlement amount. For a comparable DME supplier, the case-specific lesson is to connect the equipment billed with a valid physician order and documented medical necessity. The release does not describe the executive assessment-editing conduct found in the separate RegalCare matter.
Scope and timing
- Authority status
- Settled
- Applicability
- Operationally relevant
- Audience
- Health systems, Provider networks
- Jurisdiction
- Federal
Why it matters
DME claims depend on support for both medical necessity and the physician’s order. This settlement identifies an alleged weakness in those controls; it does not establish an assessment-override scheme or an admission of liability.
Recommended action
Compliance and Revenue Cycle should sample comparable DME claims for valid physician prescriptions and patient-specific necessity, reconcile the equipment supplied with the claim, and investigate unsupported items. Treat the conduct as alleged, rather than importing admissions from another case.
Case details
- agencies
- U.S. Department of Justice
- entities
- Crown Medical Solutions LLC, Michelle King, Philanzo King
- action Type
- Settlement
- event Date
- 2026-09-21
- alleged Conduct
- Alleged Medicare billing for durable medical equipment that was not medically necessary or was not properly prescribed.
- resolution
- Crown Medical Solutions and its owners agreed to pay $825,000 to resolve False Claims Act allegations. The claims resolved are allegations only, with no determination of liability.
Operational lessons
- Match equipment billed to a valid physician prescription.
- Test patient-specific medical necessity for DME supplied.
- Keep settlement allegations separate from admissions in other cases.
Sources
- Crown Medical Solutions and Its Owners to Pay $825,000 For Fraudulent Billing SchemeOfficial · U.S. Department of Justice · 2026-09-21 · Source review 2026-10-11
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