hanger orthopedic group, inc. securities litigation 04-cv-02585-consolidated amended
TRANSCRIPT
UNITED STATES DISTRICT COURTEASTERN DISTRICT OF NEW YORK
IN RE HANGER ORTHOPEDIC GROUP, INCSECURITIES LITIGATION
CASE NO . CV-04-2585
CONSOLIDATED AMENDEDCLASS ACTION COMPLAINTFOR VIOLATIONS O FFEDERAL SECURITIES LAWS
JURY TRIAL DEMANDED
Plaintiffs, by their attorneys, on behalf of themselves and the class they represent, for
their Consolidated Amended Class Action Complaint For Violations Of Federal Securities Laws
(the "Complaint"), make the following allegations against defendants Hanger Orthopedic Group,
Inc . ("Hanger" or the "Company"), Thomas F . Kirk, George E . McHenry and Ivan R. Sabel
based upon the thorough investigation conducted by and under the supervision of plaintiffs'
counsel, which included reviewing and analyzing information and financial data concerning
Hanger relating to the "Class Period" (March 13, 2002 through September 15, 2004, inclusive)
and obtained from numerous public and proprietary sources (such as LEXIS-NEXIS, Dow Jones,
and Bloomberg), including, among other things, filings with the Securities and Exchange
Commission (the "SEC"), publicly available annual reports, press releases, published interviews,
news articles, investor conference calls, and other media reports (whether disseminated in print
or by electronic media), reports of securities analysts and investor advisory services, in order to
obtain the information necessary to plead the claims with particularity . Plaintiffs' investigation
also included interviewing or consulting with numerous individuals, including former Hanger
employees who worked at the Company during the Class Period and are knowledgeable abou t
Hanger's business and operations and/or the industry and markets in which Hanger operates .
Except as alleged herein, the underlying information relating to defendants' misconduct and th e
particulars thereof are not available to plaintiffs and the public and lie exclusively within th e
possession and control of defendants and other insiders, thus preventing plaintiffs from furthe r
detailing defendants' misconduct . Plaintiffs believe that further substantial evidentiary suppor t
will exist for the allegations set forth below after a reasonable opportunity for discovery .
NATURE OF THE ACTION
This is a federal class action on behalf of purchasers of the securities of Hanger
between March 13, 2002 and September 15, 2004, inclusive (the "Class Period") seeking t o
pursue remedies under the Securities Exchange Act of 1934 (the "Exchange Act") .
2. Defendant Hanger describes itself as "the world's premier provider of orthoti c
and prosthetic patient-care services," which, as of December 31, 2003, operated 585 patient-care
facilities throughout the United States . The Company's business and stock price are crucially
dependent on maintaining compliance with federal and state rules, and on its reputation in the
health care community .
Throughout the Class Period, defendants made statements that represented tha t
Hanger's business was being operated in compliance with federal, state and local regulations ,
and was free from insurance-related fraud .
4. Unbeknownst to investors, however, as detailed herein, defendants were engage d
in an illegal scheme to bilk the Medicaid and Medicare programs, the Veterans Administration
and private insurers in order to artificially inflate the Company' s financial perform ance .
Specifically, during the Class Period, Hanger improperly booked sales by, inter alia, forging
prescriptions and other documents necessary for obtaining reimbursement from insurers
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(including Medicare and Medicaid), charging insurers for items or services that were not
prescribed for, or not provided to patients, and misrepresenting to insurers the type of items, or
the scope of the services, provided to patients - all in order to increase bills to Medicare,
Medicaid and private insurers, thereby increasing the insurance payments that Hanger received,
an in turn artificially inflating Hanger's reported financial results .
5 . These undisclosed fraudulent practices jeopardized Hanger's status as a Medicare
and Medicaid provider and its relationships with private insurers and subjected Hanger to the risk
of incurring criminal and civil penalties . These practices, therefore, were, highly material to
investors seeking to evaluate the soundness and effectiveness of the Company's operations .
6. Throughout the Class Period, Hanger represented that the financial statements tha t
it disseminated to the market accurately reflected the Company' s financial performance, were
prepared in accord ance with Generally Accepted Accounting Principles ("GAAP") and
applicable SEC regulations, and were free from material misstatement or omission . Defendants
have now restated their fin ancial statements , thereby admitting that the financial statements were
false when issued .
7. As detailed herein, in order to conceal the deteriorating state of H anger 's business
and to maintain Hanger's stock price at artificially inflated levels, Hange :r engaged in improper
revenue-inflating practices during the Class Period that enabled the Company to artificially
inflate its reported assets, accounts receivable, income and earnings per share ("EPS") at the end
of the Company's annual and quarterly reporting periods, and decrease its expenses, rendering
Hanger's financial statements and other communications regarding the Company's financial
performance complained of herein materially false and misleading .
8 . As detailed herein, Hanger's improper accounting included, inter alia :
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(a) misrepresenting to investors that the financial statements it issuedwere accurate and truthful and prepared in accordance with GAAP and the rulesand regulations of the SEC;
(b) failing to account properly for accounts receivable and bad debtexpense;
(c) failing to properly maintain an adequate system of inte rnal controlwhich rendered Hanger 's financial repo rt ing unreliable and incorrect ; and
(d) improperly recognizing the revenue it billed for, and /or received asa result of its fraudulent billing practices, while knowing or recklesslydisregarding the fact that this revenue would either not be realized, or if realized,would be subject to recoupment by insurers .
9 . The truth began to emerge on June 14, 2004, when WNBC News in New Yor k
aired an investigative report (the "WNBC News Report") in which a Hanger employee describe d
the Company's fraudulent billing practices at one of its patient-care facilities in West
Hempstead , NY (the "West Hempstead Facility"). The WNBC News Report also reported that
the Company had failed an internal audit of its patient files in the summer of 2003 , and that in a
follow-up in February 2004 - seven months later - the Company's auditor warned Hanger
officials that she was "still very concerned about the integrity of the documents I've received "
and that "[t]here remain numerous altered documents ."
10 . The next day, on June 15, 2004, the Company issued a news release stating that
the Company had been made aware of "alleged billing irregularities " at its West Hempstead
Facility when "an employee" at that facility reported the billing irregularities on the Company' s
"Compliance Hot Line ." The Company further disclosed that it had initiated an investigatio n
into the billing irregularities at the West Hempstead Facility .
11 . As a result of the disclosures on June 14 and 15, 2004, Hanger's share price
decreased substantially, from an opening price of $15 .75 per share on June 14, 2004 to a closing
price of $12 .75 per share on June 15, 2004 - a two-day decline of 19% .
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12. On June 18 , 2004, Hanger announced that it had received a subpoena from the
U.S . Attorney's Office for the Eastern District of New York relating to the allegations of billing
fraud at the West Hempstead Facility, and seeking information conce rn ing 13 other Hanger
facilities in New York State . At the same time , the Company announced that the SEC also had
requested information from the Company relating to the billing fraud allegations .
13 . As a result of the Company's June 18 , 2004 disclosure concerning the
government investigations , the Company' s shares experienced a further sharp decline, falling
from an opening price of $12 . 00 per share on June 18, 2004 to a closing price of $9 .34 on the
following trading day , June 21 , 2004 - another two-day drop of 22% .
14 . Unfortunately for Hanger 's investors, the bad news did not end there . On August
9, 2004, Hanger issued a press release announcing that it would delay its ea rnings release for the
second quarter of 2004. The Company claimed that the delay was necessary in order t o
"complete ce rtain accounting reviews . "
15 . The following day, Hanger filed a Form 12b-25 Notice of Late Filing, announcing
that the Company was delaying the release of its quarterly results because it had been unable to
timely complete the financial review "in large part due to the substantial time and effo rts
expended by management to cooperate with the inte rnal investigation of certain alleged billing
discrepancies . "
16. As the market digested these disclosures in the days following Hanger's August 9
and August 10, 2004 announcements, Hanger's already-battered shares dropped even further,
falling from a high of $9 .85 per share on August 9, 2004, before the announcements, to a low of
$4 .27 per share on August 12, 2004, for a three day decline of over 50% . Thus, by August 12,
2004, Hanger's share price had fallen over 70% from its opening price on June 14, 2004, befor e
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the WNBC New Report aired, and over 75% from its Class Period high of $19 .25 on January 22,
2004 .
17. Then, on August 16, 2004, the Company issued a press release announcing that i t
was restating its previously issued balance sheet as of December 31, 2003 and the statements o f
operations and cash flows for the six months ended June 30, 2003 to reflect "a correction of a n
error that led to the overstatement of recorded accounts receivable and an equal understatement
of bad debt expense ." According to the release, the Company' s past financial statements had
understated selling, general and administrative expense by $0 .3 million for the quarter ended
March 31, 2004, $1 .0 million for the year ended December 31, 2003 and $2 .5 million for the two
years prior to 2003 .
18. On September 15, 2004, the Company filed an Amendment to its 2003 Form 10-
K and an Amendment to its quarterly report for the first quarter of 2004. These filings restated
the Company's financial statements as of December 31, 2003, 2002 and 2001 and for the years
then ended, and for the quarter ended March 31, 2004 . The restatements materially reduced the
Company's accounts receivable and increased its selling, general and administrative expenses,
thereby reducing the Company's assets, income and EPS, as detailed herein .
JURISDICTION AND VENUE
19. The claims asserted herein arise under and pursuant to Sections 10(b) and 20(a) o f
the Exchange Act [15 U . S .C . §§ 78j (b) and 78t (a)] and Rule lOb-5 promulgated thereunder b y
the SEC [17 C .F.R. § 240.1Ob-5] .
20. This Court has jurisdiction over the subject matter of this action pursuant to 2 8
U.S .C . §§ 1331 and 1337 , and Section 27 of the Exchange Act.
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21 . Venue is proper in this District pursuant to Section 27 of the Exchange Act and 2 8
U.S .C . § 1391(b) . Many of the acts charged herein, occurred in substantial pa rt in this District
and Hanger conducts business in this District .
22 . In connection with the acts alleged in this complaint, defendants, directly o r
indirectly, used the means and instrumentalities of interstate commerce, including, but no t
limited to, the mails, interstate telephone communications and the facilities of the national
securities markets .
PARTIES
23 . Court-appointed lead plaintiffs, Les Bronte, Twist Partners, LLP, Ed and Aileen
Stiehle, Thomas Pyles, and Joe Campagnuolo, Jr ., as set forth in the certifications previousl y
filed with the Court and incorporated by reference herein, purchased the common stock of
Hanger at artificially inflated prices during the Class Period and have been damaged thereby .
24. Defendant Hanger purports to be the largest owner and operator of orthotic and
prosthetic ("O&P") patient -care centers in the United States .
25 . Defendant Ivan R. Sabel ("Sabel") was, at all relevant times, the Chairman of the
Board of Directors and Chief Executive Officer of Hanger .
26. Defendant George E. McHenry ("McHenry") was, at all relevant times, the Chief
Financial Officer and an Executive Vice President of Hanger .
27. Defendant Thomas F . Kirk ("Kirk") was, at all relevant times, Hanger's President,
Chief Operating Officer and a Director .
28 . Defendants Sabel, McHenry and Kirk are referred to herein as the "Individual
Defendants ."
29 . During the Class Period, the Individual Defendants, as senior executive officer s
and/or directors of Hanger, were privy to confidential and proprietary inf Drmation concernin g
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Hanger, its operations, finances, financial condition, present and future business prospects . The
Individual Defendants also had access to material adverse non-public information concernin g
Hanger, as discussed in detail below . Because of their positions with Hanger, the Individua l
Defendants had access to non-public information about its business, finances, products, market s
and present and future business prospects via access to internal corporate documents ,
conversations and connections with other corporate officers and employees, attendance at
management and board of directors meetings and committees thereof and via reports and other
information provided to them in connection therewith . Because of their possession of suc h
information, the Individual Defendants knew or recklessly disregarded the fact that adverse fact s
specified herein had not been disclosed to, and were being concealed from, the investing public .
30. The Individual Defendants are liable as direct participants in, and as co-
conspirators with respect to, the wrongs complained of herein. In addition, the Individual
Defendants, by reason of their status as senior executive officers and/or directors wer e
"controlling persons" within the meaning of Section 20 of the Exchange Act and had the power
and influence to cause the Company to engage in the unlawful conduct complained of herein.
Because of their positions of control, the Individual Defendants were able to and did, directly or
indirectly, control the conduct of Hanger's business .
31 . The Individual Defendants, because of their positions with the Company ,
controlled and/or possessed the authority to control the contents of its SEC filings, reports, pres s
releases and presentations to securities analysts and through them, to the investing public . The
Individual Defendants were provided with copies of the Company's SEC filings, reports an d
press releases alleged herein to be misleading, prior to or shortly after their issuance and had th e
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ability and opportunity to prevent their issuance or cause them to be corrected . Thus, the
Individual Defendants had the opportunity to commit the fraudulent acts alleged herein .
32. As senior executive officers and/or directors and as controlling persons of a
publicly-traded company whose common stock was , and is, registered with the Securities and
Exchange Commission pursuant to the Exchange Act, traded on the New York Stock Exchange
("NYSE") and governed by the federal securities laws, the Individual Defendants had a duty to
disseminate promptly accurate and truthful information with respect to Hanger ' s financial
condition and performance , growth, operations, financial statements, business , products, markets,
management, earnings and present and future business prospects , and to correct any previously
issued statements that had become materially misleading or untrue, so that the market price of
Hanger ' s common stock would be based upon truthful and accurate information . The Individual
Defendants' misrepresentations and omissions during the Class Period violated these specific
requirements and obligations .
33 . The Individual Defendants are liable as pa rticipants in a fraudulent scheme and
course of conduct that operated as a fraud or deceit on purchasers of Hanger common stock by
disseminating materially false and misleading statements and/or concealing material adverse
facts . The scheme (i) deceived the investing public regarding Hanger's business, operations and
management and the intrinsic value of Hanger common stock, (ii) enabled Hanger insiders to sell
thousands of shares of Hanger stock for hundreds of thousands of dollars in proceeds ; and (iii)
caused plaintiffs and members of the Class to purchase Hanger stock at artificially inflated
prices .
PLAINTIFFS' CLASS ACTION ALLEGATIONS
34. Plaintiffs brings this action as a class action pursuant to Federal Rule of Civil
Procedure 23(a) and (b)(3) on behalf of a Class consisting of all those who purchased th e
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securities of Hanger between March 13, 2002 and September 15, 2004 inclusive and who were
damaged thereby. Excluded from the Class are defend ants , the officers and/or directors of the
Company, at all relevant times, members of their immediate families and their legal
representatives , heirs, successors or assigns and any entity in which defendants have or had a
controlling interest .
35 . The members of the Class are so numerous that joinder of all members is
impracticable . Throughout the Class Period , Hanger common shares were actively traded on the
NYSE. While the exact number of Class members is unknown to plaintiffs at this time and ca n
only be ascertained through appropriate discovery, plaintiffs believe that there are hundreds or
thousands of members in the proposed Class . Record owners and other members of the Class
may be identified from records maintained by Hanger or its transfer agent and may be notified of
the pendency of this action by mail, using the form of notice similar to that customarily used in
securities class actions .
36. Plaintiffs' claims are typical of the claims of the members of the Class as all
members of the Class are similarly affected by defendants' wrongful conduct in violation of
federal law that is complained of herein .
37. Plaintiffs will fairly and adequately protect the interests of the members of the
Class and have retained counsel competent and experienced in class and securities litigation .
38 . Common questions of law and fact exist as to all members of the Class an d
predominate over any questions solely affecting individual members of the Class . Among the
questions of law and fact common to the Class are :
(a) whether the federal securities laws were violated by defendants'acts as alleged herein;
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(b) whether statements made by defendants to the investing publicduring the Class Period misrepresented material facts about the business andoperations of Hanger; and
(c) to what extent the members of the Class have sustained damagesand the proper measure of damages .
39 . A class action is superior to all other available methods for the fair and efficient
adjudication of this controversy since joinder of all members is impracticable . Furthermore, as
the damages suffered by individual Class members may be relatively small, the expense an d
burden of individual litigation make it impossible for members of the Class to individuall y
redress the wrongs done to them . There will be no difficulty in the management of this action a s
a class action .
SUBSTANTIVE ALLEGATION S
40. Defendant Hanger is an owner and operator of over 580 orthotic and prostheti c
("O&P") patient-care centers in the United States. In the Company's orthotics business, it
designs, fabricates, fits and maintains a wide range of standard and custom-made braces and
other devices. In the Company's prosthetics business, it designs, fabricates, fits and maintains
custom-made artificial limbs . Hanger derived 44 .8%, 43 .9%, and 40.5% of its net sales for the
years ended December 31, 2003, 2002 and 2001, respectively, from reimbursements for O& P
services and products from programs administered by Medicare, Medicaid and the U . S . Veterans
Administration .
41 . Most of Hanger's customers are patients who are covered by either private healt h
insurance or health insurance provided by government programs such as Medicare, Medicaid an d
programs run by the Veteran' s administration . Typically, patients in need of Hanger's O& P
products and services are referred to Hanger by a physician or hospital . The referring physician
provides a prescription listing the type of product or service that the patient needs . A practitioner
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(either a prosthetist or orthotist) at one of Hanger's patient-care facilities - who is typically not
a physician - is then supposed to provide the patient with the prescribed product or service and
the practitioner and administrative staff is supposed to ensure that the documentation necessary
to properly obtain payment from the patient's insurer is present in the patient's file .
42. Although the documentation required for payment from insurers differs slightly
depending on the insurer, typically, the necessary documentation includes, inter alia :
(a) a valid prescription, signed and properly dated by the referringphysician, which describes the product to be provided to the patient and which is"free of any signs of alteration;"
(b) a Validation of Receipt/Delivery Acknowledgement ("VOR"),signed and properly dated by the patient, which notes the quantity, the type of unitand/or description of the item, and in which the patient acknowledges receipt, anddate of receipt, of the product ;
(c) a HIPAA Notice of Privacy Practices Form, signed and properlydated by the patient, stating that the patient has received a brochure discussing thepatient's privacy rights under the Health Insurance Portability and Accountability
Act of 1996;
(d) an Assignment of Benefits/Authorization to Release Informationform, signed and properly dated by the patient, in which the patient requests thatthe patient's insurer pay insurance benefits directly to Hanger for the service orproduct provided and authorizes the release of any of the patient's medica linformation that is necessary to determine insurance benefits ; and
(e) Clinical Notes, sometime referred to as "Progress Notes,"prepared, signed, and properly dated by the attending practitioner, justifying theparticular product or service provided to the patient . For prosthetic patients, theClinical Notes must "include the patient's current and expected functional levels,explain any differences, and document agreement by the referring physician."
In addition, some insurers require that a patient's file include a Certificate of Medical Necessity,
signed and dated by the referring physician, which states why the patient needs the prescribed
product or service .
43 . For some insurers, Hanger was not required to submit the necessary
documentation to insurers at the time Hanger billed insurers for the products or service s
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purportedly provided to patient . However, all insurers required Hanger to have all of the above
documentation - in complete and compliant form - in a patient's file before billing the
patient's insurer. Further, all documentation kept in a patient's file is required to be "free of any
signs of alteration ." Throughout the Class Period, defendants were aware of these requirements .
Defendants were further aware that in the event any patient files were missing any of the
required documentation, or any of the documentation was the product of fraud, Hanger ran the
significant risk of non-payment by the patient's insurer or recoupment by the insurer of any
payments previously made.
44 . For each patient that Hanger serviced, the attending practitioner was required t o
complete a "Patient Data Sheet" or similar form that states the patient's identifying information,
lists the date of delivery to the patient of the product or service, describes the product or service
provided to the patient (as well as any repairs or replacements to the product), lists the code
number of the product or service provided (the "Billing Code"),' and states the charges incurred
and balance due from the patient and/or the patient's insurer . After a patient has been provided
the prescribed product or service, and the necessary documentation is complete and present with
the patient's file, a Hanger representative submits billing information to the patient's insurer
requesting payment .
45 . Throughout the Class Period, defendants were aware that Hanger's complianc e
with these requirements, and with the federal, state and local government regulations that
governed its operations - and in particular, compliance with Medicare and Medicaid regulations
- was of critical importance to the Company . Defendants knew that non-compliance could
result in significant penalties to the Company, including its exclusion from the Medicare and
' The Billing Code entered onto the Patient Data Sheet is a number preceded by a letter of the alphabet (e.g.,"L5680") which corresponds to an O&P item or service that has been approved for billing by insurers .
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Medicaid programs, as well as damage Hanger's reputation and credibility. In its annual report
on Form 10-K for the year ended December 31, 2003 ("2003 Form 10-K"), the Company state d
that "[f]ailure to comply with applicable governmental regulations may result in significan t
penalties, including exclusion from the Medicare and Medicaid programs, which could have a
material adverse effect on our business ." Specifically, the Company stated that any advers e
governmental review, audit or investigation could result in "refunding of amounts we have bee n
paid pursuant to our government contracts ; imposition of fines, penalties and other sanctions o n
us; loss of our right to participate in various federal programs ; damage to our reputation in
various markets ; or material and/or adverse effects on the business, financial condition, an d
results of operations ."
46. Accordingly, throughout the Class Period, defendants were fully aware of the
fundamental dangers to its business that would result from non-compliance and fraud related t o
its insurance billing .
47. Defendants reassured investors, however, that they "make every effort" t o
maintain compliance, and that they had the appropriate procedures in place to maintai n
compliance. In this regard, the Company's 2003 Form 10-K and its annual report on Form 10- K
for 2002 ("2002 Form 10- K") stated as follows :
We are subject to a variety of federal, state and local governmentalregulations . We make every effort to comply with all applicable regulationsthrough compliance programs, manuals and personnel training . Despite theseefforts, we cannot guarantee that we will be in absolute compliance with allregulations at all times .
Fraud and Abuse . Violations of fraud and abuse laws are punishable bycriminal and/or civil sanctions, including, in some instances, imprisonment andexclusion from participation in federal healthcare programs, including Medicare,Medicaid, U.S. Veterans Administration health programs and the Department ofDefense's TRICARE program, formerly known as CHAMPUS . These laws,which include but are not limited to, antikickback laws, false claims laws ,
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physician self-referral laws, and federal criminal healthcare fraud laws, arediscussed in further detail below . We believe our billing practices, operations,and compensation and financial arrangements with referral sources and others
materially comply with applicablefederal and state requirements. However, wecannot assure that such requirements will not be interpreted by a governmentalauthority in a manner inconsistent with our interpretation and application . Thefailure to comply, even if inadvertent, with any of these requirements couldrequire us to alter our operations and/or refund payments to the government . Suchrefunds could be significant and could also lead to the imposition of significant
penalties . Even if we successfully defend against any action against us forviolation of these laws or regulations, we would likely be forced to incursignificant legal expenses and divert our management's attention from theoperation of our business . Any of these actions, individually or in the aggregate,could have a material adverse effect on our business and financial . results . [ . . . ]
False Claims Laws . We are also subject to federal and state lawsprohibiting individuals or entities from knowingly presenting, or causing to bepresented, claims for payment to third-party payors (including Medicare andMedicaid) that are false or fraudulent, are for items or services not provided asclaimed, or otherwise contain misleading information . Each of our patient-carecenters is responsible for preparation and submission of reimbursement claims tothird-party payors for items and services furnished to patients . In addition, ourpersonnel may, in some instances, provide advice on billing and reimbursement topurchasers of our products . While we endeavor to assure that our billing
practices comply with applicable laws , if claims submitted to payors are deemedto be false, fraudulent, or for items or services not provided as claimed, we couldface liability for presenting or causing to be presented such claims . [Emphasis
added . ]
48. Hanger's 2003 Form 10-K and 2002 Form 10-K also represented that th e
Company "monitor[s] centrally" each individual patient-care center's billing and collections o f
accounts receivable , and provides each center with "all senior management [and] accounting . . .
services ."
49. Defendants' statements referenced above in ¶¶ 45, 47 and 48 were each materiall y
false and misleading when made because they failed to disclose and misrepresented th e
following material adverse facts , discussed in detail below at ¶¶ 51-77 :
(a) Hanger was systematically engaging in fraudulent billing practices,including falsifying prescriptions : and other billing documentation submitted tothird party payors, in order to artificially inflate its reported revenues an d
earnings ;
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(b) the Company's purported risk warnings failed to disclose that theCompany had falsified billing records and defrauded federal and stategovernments and private insurers thereby placing its accreditation at serious risk ;
and
(c) the Company suffered from material deficiencies in its internalcompliance controls, including inadequate auditing and supervision of its patientcare facilities to ensure compliance with federal, state, and local regulation andthe requirements of private insurers .
50. Further, defendants caused the Company to file reports with the SEC during the
period June 2003 through June 2004, including quarterly reports on Form 10-Q for each quarter
during this period, that were materially false and misleading in that they jailed to disclose the
material adverse facts affecting the Company alleged in ¶ 49 above and discussed in detail in
¶¶51-77 below .
HANGER'S FRAUDULENT BILLING SCHEM E
51 . In furtherance of its scheme to inflate revenue and earnings, Hanger engaged in
systematic and flagrant billing fraud at its patient care facilities, as witnessed by several
knowledgeable former employees of the Company .
52 . Hanger's brazen billing fraud was witnessed by, inter alia, a former Office
Administrator who worked at Hanger's West Hempstead Facility from June 2003 to June 2004
(the "Office Administrator") . The Office Administrator's daily job responsibilities included,
inter alia, processing patients' bills, billing insurers for items and services provided to patients,
requesting authorization from insurers to bill for payment, verifying patients' insurance
eligibility, and coordinating with practitioners working out of the West Hempstead Facility and
certain other Hanger facilities in New York concerning insurance billing documentation - job
responsibilities that put the Office Administrator in a position to have first-hand knowledge of
the fraudulent billing practices that Hanger engaged in at the West Hempstead Facility .
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53 . Among the fraudulent practices that the Office Administrator witnessed at th e
West Hempstead facility during the period from June 2003 to June 2004 were the following :
(a) Practitioners forged prescriptions, Certificates of Medical
Necessity and other insurance-related documentation that were necessary to
support the patient bills that Hanger submitted to insurers . For example, in May2004, the Office Administrator witnessed Gennaro Ritieni ("Ritieni"), the FacilityManager and head practitioner of the West Hempstead Facility, forge thesignature of Dr . Carl Richie, the referring physician for a patient named GeraldineMcKoy, on a Prescription and a Certificate of Medical Necessity . Copies of thisforged Prescription and Certificate are attached hereto as Exhibit A . In anotherinstance, in May 2004, the Office Administrator witnessed Ritieni cut thesignatures of patients and physicians from existing documents and pasted themonto billing-related documents, such as VORs and prescriptions, that needed, butdid not have those signatures . A copy of a VOR that Ritieni forged in this manner
is attached hereto as Exhibit B . To enable these forgeries, Ritieni photocopiedblank prescription pads that had been obtained (presumably, illicitly) fromElmhurst Hospital .
(b) Practitioners, and other employees in the facility acting at thepractitioners' behest, improperly submitted Billing Codes to insurers forproducts that were more expensive than the products actually provided topatients, thereby resulting in higher payments to Hanger by insurers .
(c) Practitioners improperly back-dated insurance billing documents,
including VORs, listed phony dates on billing documents, and dated documentsthat were required to be dated only by the patient. For example, in one case, theOffice Administrator was instructed by practitioners, including Lisa Constantine("Constantine"), to submit a stack of patient bills to insurers on May 1, 2004 eventhough the dates of service listed on the supporting documentation in the patients'files were in mid-May 2004 - a clear indication to the Office Administrator thatthe supporting documentation had been falsified .
(d) Practitioners and other employees improperly billed insurers foradd-on items that were never prescribed by the referring physician. For example,throughout the Class Period, patients whose prescriptions called for the patient tobe provided a pair of shoes routinely would be provided, and Hanger wouldsubsequently bill their insurers for, orthotics and padding in addition to the shoes .In each instance of this type of fraud, the addition to the bill of the padding alonecould result in an additional cost to the insurer, and payment to Hanger, ofapproximately $125, whereas the shoes alone cost only approximately $25 - a500% mark-up. This fraudulent practice was so pervasive that some insurerseventually refused to pay Hanger for such add-on items .
(e) Practitioners and other employees improperly billed insurers for
each componentpart of a product purportedly provided to a patient, rather than
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billing for the item as a whole, in order to reap the higher price of thecomponent parts .
(f) Hanger improperly billed insurersfor items and services thatwere not actually provided to patients . For example, in March 2004, Ritieniprovided a prosthetic leg to a patient named Johnnie Cole, who was a singleamputee, but listed Cole as a double amputee and billed Cole's insurer for twoprosthetic legs rather than one .
(g) Practitioners improperly signed and/or dated VORs themselves,and often did so before the patient had even received the product or service forwhich Hanger billed insurers, despite the fact that VORs were supposed to besigned and dated only by patients, and only after the patient had received theproduct or service .
(h) Practitioners instructed Hanger employees responsible for billing,
such as the Office Administrator , to use the Billing Codes that corresponded tothe most expensive product within a product category, regardless of whether the
patient actually received that product. For example, throughout the Class Period,
the Office Administrator routinely was instructed by practitioners to bill for
custom-made items (e.g., custom-molded shoes) rather than off-the-shelf items,
even though the patient had been prescribed, and had received, the off-the-shelf
item.
(i) Hanger employees improperly fabricated false diagnoses for
patients, and recorded such fabricated diagnoses in the patient's file, in order to
justify the provision of products or services that Hanger billed to insurers . For
example, the Office Administrator was often instructed to list a patient assuffering from a severe type of diabetes, despite the fact that that diagnosis was
not accurate, solely for the purpose of "justifying" to insurers the product that
Hanger billed with respect to that patient .
54. Based on her first-hand knowledge, the Office Administrator estimates that ,
taking into account the fraudulent activities of only two practitioners at the Facility (Ritieni an d
Constantine) - and not even counting all the other practitioners at the Facility and at othe r
Hanger facilities who engaged in similar fraudulent activities - Hanger forged or otherwis e
improperly tampered with billing documentation in connection with approximately 4000 patient
files for the period from June 2003 to June 2004 . According to the Office Administrator, the
vast majority of the revenue obtained by the West Hempstead Facility during this period -
which Hanger has stated was $1 .9 for 2003 and $0.9 million for the first half of 2004 - was
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obtained through fraudulent billing practices . Although the total amount of revenue that Hanger
fraudulently billed for, or received, is exclusively within the knowledge of the Company, and has
not been disclosed, the fraudulent revenue relating to only the West Hempstead Facility - and
not counting the other Hanger facilities that participated in similar fraud, as alleged herein - is
reasonably believed to be over $1 million .
55 . Hanger's bonus compensation policies encouraged these fraudulent billing
practices. Every six months, Hanger dispensed a bonus sum to each Regional Manager, which
the Regional Manager was authorized to distribute to the managers and practitioners within his
or her region based on the amount of money that each facility within that region billed for and
collected. This policy of tying bonuses to money billed for and collected encouraged Regional
Managers, and the Facility Managers, practitioners and other employees that reported to them, to
inflate bills and seek to collect as much money from insurers as possible, without regard to
compliance with federal, state and local regulations and the requirements of insurers .
56 . Hanger further encouraged the billing fraud by pressuring its practitioners and
staff to meet unrealistic revenue targets . For example, Regional Managers held "revenue
meetings" attended by, inter alia, Facility Managers, practitioners, office administrators and
other employees of Hanger's facilities, in which the revenue targets and revenue billed for, and
collected to date, were discussed . According to the Office Administrator., one such "revenu e
meeting" was held in April 2004, which was led by David Zwicker ("Zwi.cker"), the Regional
Manager for Hanger's New York region, and attended by the Office Adrr, inistrator, Ritieni and
other employees of the facilities in the New York region . At this meeting, Hanger employees
were shown slides comparing the amount of revenue that each Hanger region, and each facility
within each of those regions, had billed for and collected for 2003, and displaying whether, base d
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on revenue generated during the first quarter of 2004, each facility was in line to meet pre-
established revenue projections for the full year 2004 . Further, Hanger employees were shown
slides displaying each region's, and each facility's, revenue ranking compared to other regions
and facilities . Unsurprisingly, given the massive fraud occurring at the West Hempstead facility ,
the West Hempstead facility and the New York Region consistently ranked among the top 5
facilities and regions in the country . Hanger held similar "revenue meetings" every six months ,
including one such meeting in October 2003 .
57. Zwicker, the Regional Manager for H anger 's New York region, was fully aware
of, and indeed encouraged, the fraudulent and illegal activity that was rampant at the West
Hempstead facility . For example, according to the Office Administrator :
(a) At a May 2004 meeting at the West Hempstead Facility attendedby several Hanger employees, including the Office Administrator and Ritieni,Zwicker stated that the Facility was committing "illegal acts" and that if anyoneoutside the Company were to enter the Facility and see what was occurring there,"the office would bepadlocked. " Despite these statements, Zwicker took noaction to stop the illegal activity occurring at the Facility, and indeed the activitycontinued thereafter . For example, according to the Office Administrator, in May2004, after the above-mentioned meeting, Ritieni requested that the OfficeAdministrator take home a stack of patient files and have her son sign the formsthat needed signatures .
(b) In June 2004, Zwicker attempted to eliminate a $30,000 revenueshortfall at other facilities in the New York Region by instructing the West
Hempstead Facility to bill $30,000 for a prosthetic leg for a patient (Geraldine
McKoy) whose documentation was incomplete and non-compliant . Zwicker told
the Office Administrator that, despite the patient's incomplete and non-compliant
documentation, he wanted the patient's insurer to be billed for the product .
Ritieni complied with Zwicker's instructions by forging the missing
documentation for the patient (including the prescription) . Copies of the forged
documentation are attached hereto as Exhibit A . According to the Office
Administrator, in demanding that the patient's insurer be billed despite theabsence of proper supporting documentation, Zwicker's sole interest was that theprice of the billed-for product was sufficiently high to cover the $30,000 revenue
shortfall .
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58. According to the Office Administrator, given the lax oversight by Hanger, and the
encouragement and participation of Zwicker, Ritieni and other practitioners at the Facility were
more afraid of falling short of the revenue targets that Hanger had set for them - and thus
jeopardizing their bonuses - than of being caught and fired for fraud .
59. Hanger's fraudulent billing practices were not the product of rogue employee s
operating exclusively at one facility or one region without Hanger's knowledge, but were
pervasive at various Hanger facilities across the country. Several former employees of the
Company witnessed similar fraud during the Class Period at Hanger's facilities in Charlotte, NC ,
Aurora, CO, Denver, CO, Brooklyn, NY, Pittsburgh, PA, and Rancho Mirage, CA. For example :
(a) A former Hanger employee who worked as an orthotist inHanger's Charlotte, NC facility during the Class Period witnessed severalinstances of "upcoding," i.e., billing for a product or service that was moreexpensive than the product or service actually provided to the patient . According
to this orthotist, Michael Jenks ("Jenks"), the Branch Manager of the Charlottefacility, often would add additional products to a patient's bill (e .g., specialpadding, special closure kits, or special strapping) that the patient had notreceived. This orthotist also witnessed Jenks change the Billing Code on patients'records in order to increase the charge to the patient's insurer, often increasing thebill by thousands of dollars . For example, Jenks fraudulently changed the BillingCode recorded for one patient from a "pelite liner" to a "gel locking liner," whichimproperly added approximately $2000 to that patient's bill . Further, accordingto this orthotist, Jenks received blank prescription pads from a physician at aclinic with which Hanger did business . In violation of compliance requirements,Jenks would fill out prescriptions for patients prescribing whatever products Jenkswanted to bill for and then fax the prescription to the patients' physicians for theirsignatures .
(b) A former Hanger employee who worked as a Fitter/OfficeAdministrator at Hanger's Aurora, CO facility from September 2003 to July 2004witnessed improper "upcoding" at that facility, including, for example, billinginsurers for a more expensive custom-made product rather than for the off-the-shelf product that was actually provided to the patient .
(c) According to a former Hanger employee who worked in theAccounts Payable department of Hanger's Denver, CO facility from January 2003to April 2004, often when Medicare, Medicaid and private insurers would returnbilling forms to the facility that were not completed correctly, this formeremployee's manager instructed him to input certain Billing Codes on the form s
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regardless of whether the patient actually received the product or service thatcorresponded to the Billing Code that had been inputted . In a further indicationthat this facility was billing insurers for products or services not provided topatients, this former employee often heard directly from patients that they had notreceived all the items listed on their "Explanation of Benefit" forms provided bytheir insurers . According to this former employee, the manager of the Denverfacility often submitted bills to insurers for services to patients that had not beencompleted - a practice that the Regional Manager in charge of this facility wasaware of, and knew to be fraudulent .
(d) According to the Office Administrator, in December 2003 orJanuary 2004, Michelle Hickman ("Hickman"), an office administrator inHanger's Brooklyn facility met with Ritieni in the West Hempstead Facility andtold Ritieni that, in order to "fix" patient files that did not have the proper billingdocumentation, she routinely would "cut and paste" the signatures of patients andphysicians from others documents onto the documents that needed signatures .Tellingly, in a company-wide newsletter issued to all Hanger facilities throughoutthe country after this incident (in approximately January or February 2004), theBrooklyn office was named "Most Improved Office" with respect to compliance,and specifically praised Hickman in this respect .
(e) One former Hanger employee responsible for patient billing inHanger's Pittsburgh facility during the Class Period was privy to numerousinstances where Hanger billed insurers for products that were different than theproduct that the patient at issue had actually received .
(f) According to a former Hanger employee who worked as a FacilityManager and practitioner in the Rancho Mirage, CA facility from February 1996to April 2003, her supervisor instructed her to input Billing Codes for additionalservices or products that were not provided to patients, and routinely instructedher to input the most expensive Billing Codes for patients, regardless of whetherthe Billing Code accurately reflected the item provided to the patient.
(g) Another former Hanger employee who worked as an OfficeAdministrator in the Rancho Mirage, CA facility from May 1997 to June 2003was aware that the facility was inputting Billing Codes that did not reflect theactual services provided to patients .
60. As at the West Hempstead Facility, Hanger's managers at these other facilitie s
created an environment that fostered fraudulent billing in order to meet ever-increasing revenu e
targets . For example :
(a) According to a former H anger employee who worked an orthotistin Hanger 's Charlotte, NC facility during the Class Period , practitioners wereunder tremendous pressure to meet unrealistic revenue quotas . In one staff
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meeting attended by this orthotist, Mike Jenks, the Branch Manager of theCharlotte facility, stated that he did not care how the revenue quotas were met butthat he wanted the quotas met on paper, and that he wanted the staff to do"anything and everything" to meet the quotas . At this meeting, Jenks further toldthe staff that their bonuses would suffer if the quotas were not met .
(b) According to a former Hanger employee who worked as a
Fitter/Office Administrator at Hanger 's Aurora, CO facility from September 2003
to July 2004, Hanger expected the facility to meet unrealistically high revenuegoals .
(c) According to a Hanger employee responsible for patient billing inHanger's Pittsburgh facility throughout the Class Period, Fran Volker, theRegional Manager in charge of the Pittsburgh facility, imposed on practitionersunrealistically high expectations as to the amount of revenue that that facilityshould have been generating .
61 . Defendants were aware of, or recklessly disregarded, these billing practices sinc e
at least July 2003 , when the Company conducted an audit of the West Hempstead Facility . On
July 21, 2003 , Donna Crouse ("Crouse"), Hanger ' s Compliance Auditor, conducted an audit of
that facility, consisting in part of a review of the documentation contained in 15 patient files,
including the files of 12 Medicare patients (the "July Audit ") . The facility failed the audit
miserably - out of a maximum possible score of 100%, with 80% being the minimum score that
Hanger considers "compliant," the facility scored only 50.93% .
62. The July Audit revealed a host of deficiencies in the 15 patient files that were
audited, including deficiencies with respect to prescriptions and Clinical Notes in 14 of 15 file s
and deficiencies with respect to VORs in all 15 files . According to the Company's Audi t
Summary of the July Audit, the July audit revealed, inter alia, that :
(a) certain patient files contained non-compliant prescriptions(including prescriptions that did not describe the patient's diagnosis or the BillingCodes to be billed) ;
(b) certain patient files were completely lacking any Clinical Notes orcontained Clinical Notes that did "not provide justification . for our services," orthat stated simply "Seen by Jerry" or "Seen by Maxwell," without furtherexplanation ;
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(c) certain Patient files were completely lacking any VOR orcontained a VOR that was not signed or dated by the patient ;
(d) certain Patient files were completely lacking any Assignment ofBenefits form and/or HIPAA Acknowledgement form ;
(e) Hanger had submitted bills to insurers for multiple products eventhough the supporting documentation in the patient's file either did not suggestthat any product was actually provided to the patient, confirmed that only oneproduct was actually provided, or suggested that the billed .-for product was nevereven fabricated, much less provided . For example, with respect to severalpatients, the Audit Summary noted that Hanger had "billed for 2 test sockets,however there are no notes to verify that any test sockets were provided," or thatHanger had "billed for 2 test sockets, however the notes indicate that only 1 testsocket was provided ;" and
(f) Hanger had submitted bills to insurers on dates that preceded thedate of delivery of the product to the patient . For example, the Audit Summaryfound with respect to one patient that : "There is no VOR, but indicates that pt[i .e ., patient] got an aircast and shoes . However, notes for aircast show it wasdelivered 6/19, shoes were delivered 7/ /03 [sic] . HCFA shows all were billedwith DOS [i .e ., "Date of Service"] 6/19 . This should have been two differentdates of service, one for the aircast, one for the shoes ."
63. Crouse noted her suspicion that documents in patients ' files were being
improperly altered by Hanger employees . In an email that Crouse sent to the West Hempstea d
Facility, Crouse stated : "Remember that you cannot alter a document after it has been signe d
by a patient or physician. The only changes you are permitted to make is to add the patient's
address, the physician's address and/or UPIN to the prescription. Any other changes affec t
the integrity of a document ." [Original emphasis . ]
64 . With respect to many patient files audited in the July Audit, Crouse noted that
because of the lack of supporting documentation the facility would need to "refund Medicare and
any other payer" for products that were "billed for but not fabricated." Ultimately, Hanger
determined that $160,000 needed to be refunded to insurers with respect to the limited number o f
patient files audited in the July Audits, and without even counting the thousands of other patien t
files that had not been audited . However, despite Crouse's acknowledgment that the payments
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relating to certain patients would need to be refunded to insurers, according to the Office
Administrator, Hanger did not do so during the Class Period . Instead, according to the Office
Administrator, rather than refund the payments relating these patients - which would have
reduced the Facility's revenue and thereby jeopardized the Facility's, and . the Facility's
practitioners' bonuses Ritieni and other practitioners at the West Hempstead Facility forged,
altered and otherwise improperly completed the necessary documentation for these patients .
65. Hanger's routine audit procedures required that, in response to the July Audit, th e
West Hempstead facility had to "take corrective action" and provide the Compliance Auditor a
"Management Response" within 10 days of the audit . The facility also vv as required to obtain
and forward to the Compliance Auditor all missing documentation for the audited patient files
within 90 days, including an explanation of "how each of the specific deficiencies will be
corrected, as well as an action plan outlining how similar errors will be avoided in the future . "
66. Despite these requirements, however, according to the Office Administrator, th e
West Hempstead Facility never provided the Management Response, never provided the "action
plan," and as of December 2003, had not provided the corrected documentation. According to an
internal Hanger email from Crouse to the West Facility dated December 9, 2003, Crouse had still
not received "any of the corrected documentation from the July audit" by December 9, 2003 5
months after the audit, and over 6 weeks after the corrected documentation was due . According
to an email from Crouse to the West Hempstead Facility dated May 7, 2004, the facility had still
not submitted all the corrected documentation for the July Audit by May 7, 2004 - over 9
months after the audit and over 6 months after the corrected documentation was due . However,
according to the Office Administrator, apart from sending emails to the facility reminding it to
submit the documentation, Hanger took no action to obtain the corrected documentation, t o
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further investigate the billing discrepancies revealed by the July Audit, o :- otherwise to prevent
the fraud that was occurring at the West Hempstead Facility .
67 . Instead, in November 2003, Hanger purported to conduct a second audit of the
West Hempstead Facility (the "November Audit") . In reality, the November Audit was a sham
designed to give the appearance that the problems identified in the July Audit had been
addressed and that the West Hempstead Facility was now "compliant ." Of the thousands o f
patient files maintained at the West Hempstead Facility, Hanger audited only ten. This number
of files was inadequate to measure compliance, especially given the Facility's failure of the July
Audit, which suggested that a more thorough, rather than less thorough follow-up audit needed to
be conducted. Further, with respect to those ten patient files, Hanger thwarted one of the mai n
purposes of a random audit by providing the facility two weeks advance notice of which ten
patient files would be audited, allowing the Facility ample time to alter, forge and otherwise
"correct" any non-compliant files among those ten patient files . Further, Hanger did not even
bother to re-audit the non-compliant files reviewed in the July Audit, for which the West
Hempstead Facility had failed to submit the corrected documentation as requested by Crouse and
required by Hanger's audit policy .
68 . In conducting the November Audit, Hanger found several patient files that were
missing documentation or that had other indicia of fraud . Despite this, Hanger gave the West
Hempstead Facility a score of 80% - the minimum passing score .
69 . Internal Hanger documents prepared after the November Audit, however,
demonstrate that the West Hempstead Facility remained far from compliant, to say the least . On
February 13, 2004, Crouse sent an email to the West Hempstead Facility and Ritieni, on which
Zwicker and Jerry Johnson, Hanger's Senior Compliance Auditor, were copied, concerning th e
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corrected documentation that she had received from the facility in response to the July Audit . In
the email, Crouse again noted her suspicion that fraud was occurring at the West Hempstead
Facility : "I am still very concerned about the integrity of the documents I have received for
the July Audit. There remain numerous altered documents , which cannot be accepted
because they are not compliant." Crouse's email continues by listing the examples of altere d
documents that she found, such as : "Documents that were signed but not dated by the patient at
the time of the audit, but are now dated (not dual dated). Or VOR 's that were missing th e
description of all codes billed, but now have all the descriptions on them, again not dual dated .
Also, of conce rn is the large number of outstanding documents ." Crouse's email goes on to lis t
the deficiencies in specific patient files that had failed the audit, noting that "it is not legal to add
a date after the patient has signed the document ." With respect to the documents in anothe r
patient file, Crouse noted , "Were they backdated?"
70 . Although Crouse claimed to be "very concerned" about th-- integrity of th e
facility's documents, both she and Hanger recklessly failed to take any follow-up action . For
example, according to the Office Administrator, Hanger never conducted a follow-up visit to the
facility for the purpose of reviewing the originals, rather than the copies, of the audited patien t
files which were available for review at the West Hempstead facility . According to the Offic e
Administrator, had Hanger done so, it would have been readily apparent that much of th e
"corrected" documentation in the audited patient files were obviousforgeries . For example, th e
original documents contained in certain patients' files clearly showed the paper fragment s
containing patient signatures that Ritieni had cut from other documents in the patient's file an d
pasted onto the necessary documentation . An example of the patient documentation that was
forged in this "cut-and-paste" manner is attached hereto as Exhibit B .
-27-
71 . Crouse's February 13, 2004 email is direct evidence that tie Company's auditors
and senior managers - including the Senior Compliance Auditor and the Regional Manager for
the New York region - were either aware of fraudulent and illegal conduct occurring at the
West Hempstead facility, or at a minimum, recklessly disregarded the evidence of such conduct .
Despite the numerous indications of fraudulent and illegal conduct noted in the email, including
Crouse's doubts about the "integrity of documents," "altered documents," and the "illegal"
dating of documents, according to the Office Administrator, the Company took no action to
prevent the fraud at the West Hempstead facility, which continued unabated at least until the
WNBC News Report aired on June 14, 2004 .
72. Further, the West Hempstead Facility's high revenue rankings combined with the
indicia of fraud uncovered by the July Audit provided defendants with unmistakable signs of
fraudulent billing activity which Hanger knowingly or recklessly disregarded . Hanger was
aware of the unusually large amount of revenue generated by the West Hempstead Facility
compared to other facilities in New York and around the country . For example, according to the
figures in the slides displayed at the April 2004 "revenue meeting," and witnessed by the Office
Administrator, the West Hempstead Facility generated approximately twice as much revenue as
Hanger's facility in Westbury, NY, even though the West Hempstead Facility employed
approximately half as many practitioners as the Westbury facility .
73 . Moreover, Hanger's centralized computerized billing system - known as "OPS"
- further suggests that Hanger was aware of, or recklessly disregarded, the billing fraud
occurring at its various facilities throughout the country . By virtue of OPS, in 2003 and 2004
Hanger's corporate headquarters had the ability to view in real-time the billing information that
was being inputted into the OPS system for particular patients by Hanger employees at facilitie s
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throughout the United States . The fraud that was being committed at Hanger's facilities woul d
have been readily apparent to anyone at Hanger's corporate headquarters who made use of thi s
capability . For example, the West Hempstead Facility inputted the exact same Billing Code fo r
every diabetic patient treated at that facility - a circumstance that is inherently implausible and
highly suspicious, given that not all diabetic patients have the same level or type of disability or
need the same O&P products or services .
74. Hanger also signaled its approval of artificial revenue inflation practices b y
routinely instructing its facilities to keep their books open beyond the end of the month or the
end of the quarter in order to inflate the revenue generated during the period at issue. For
example :
(a) According to a former Hanger employee who worked as a FacilityManager and practitioner in the Rancho Mirage, CA facili- .̀y from February 1996
to April 2003, Hanger closed the books after the end of the month, usually in
months at the end of quarters, when Hanger filed its quarterly reports with the
SEC .
(b) Another former Hanger employee who worked as an OfficeAdministrator in the Rancho Mirage, CA facility from May 1997 to June 2003received calls from her area administrator, and even emails from Hanger'scorporate headquarters, advising her to keep the facility's books open beyond theend of the month, especially at the end of the year, in order to be able to reportgreater revenue .
75 . Further, Hanger was explicitly informed of the billing fraud occurring at the Wes t
Hempstead Facility, including the involvement of the Regional Manager for the New York
region (Zwicker) and the Facility Manager for the West Hempstead Facility (Ritieni) by the
Office Administrator via a call to the Company' s Compliance Hotline on June 7, 2004 - one
week before the WNBC News Repo rt aired - in which the Office Administrator alerted Hanger
to the billing fraud and the participation of Zwicker and Ritieni in that fraud .
-29-
76. Defendants were well aware throughout the Class Period that the billing practices
discussed above constituted insurance fraud and subjected Hanger to the risk of claims for
recoupment from insurers . For example, Hanger's own compliance auditor recognized th e
impropriety of the pervasive practice of "upcoding" and charging for additional product s
components that were not provided to patients and/or not prescribed by the patient's physician .
As stated in an internal Hanger Audit Summary, "if components or add ons are not listed on th e
Rx [i .e ., prescription], payment received will be considered an overpayment ." Hanger was also
aware that forging or otherwise improperly altering prescriptions and other necessary billing
documentation was improper. An internal Hanger document states that prescription "must . . . be
signed and properly dated by the physician" and that no one other than the referring physician
may add information to a prescription, other than the patient's address, the physician's address,
and the physician's "UPIN" number .
77. Further, as demonstrated by Hanger's public statements warning of the grav e
jeopardy to the Company' s business of non-compliance and fraud ( alleged above in paragraph s
¶¶ 47 and 48 above) defendants knew that these fraudulent practices put the Company at the ris k
of suffering fundamentally debilitating consequences . These consequences included, but were
not limited to (i) "criminal and/or civil sanctions, including, in some instances, imprisonment"
(ii) exclusion from participation in federal healthcare programs, including, Medicare, Medicaid,
U .S . Veterans Administration health programs," (iii) "liability for presenting or causing to be
presented such claims." Defendants further were aware that these consequences could have a
"material adverse effect on [the Company's] business and financial results . "
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HANGER'S MATERIALLY FALSE AND MISLEADING FINAN CIAL STATEMENT S
78 . Throughout the Class Period, defendants consistently represented to investors tha t
its financial statements accurately reflected the financial results of the Company, that its financia l
statements were prepared in accord ance with GAAP, that it recognized revenue in accordance
with GAAP and that its financial statements were devoid of material misstatements and
omissions .
79 . The Class Period begins on March 13 , 2002, when Hanger announced its financia l
results for the fourth quarter of 2001 and the full year 2001 . In a press release that day, Hanger
announced "record sales and incomefrom operations " for the fourth quarter of 2001 and th e
year ended December 31, 2001 . The Company stated that net sales for 2001 reached a "record"
$508 .1 million, an increase of $22.1 million or 4.5%, over the prior year's net sales of $486 . 0
million. The Company attributed the increase primarily to an " increase in same center sales in
the Company's O&P practices." The release further stated that "the Company reported incom e
before income taxes of $16 .5 million in 2001 compared to a pretax loss o f $13 .1 million in the
prior year, an improvement of $29 .6 million ." The Company reported results for 2001, i n
relevant part, as follows :
Net sales for the year ended December 31, 2001, reached a record$508.1 million, an increase of $22 .1 million or 4 .5%, over the prioryear's net sales of $486 .0 million . This sales growth was primarilydue to a 6 . 8% increase in same center sales in the Company's O&Ppractices, offset by a reduction in sales due to the sale of SOGI .Gross profit for the year ended December 31, 2001 improved by$32.5 million, or 4 .3% as a percentage of sales, to $267 .2 million,or 52.6% of net sales, compared to $234 .7 million, or 48 .3% of netsales, in the prior year . The gross margin was favorably impactedby the increase in net sales along with a reduction in the costs ofmaterials and labor resultingfrom various performanceimprovement initiatives implemented during 2001 . [Emphasisadded .]
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Commenting on these results, defendant Sabel stated in the release : "We have improved our
operations [and] increased our cash flow . . . . "
80 . On April 1, 2002, Hanger filed with the SEC its Annual Report on Form 10-K for
the year ended December 31, 2001, which was signed, inter alia, by defendants Sabel and
McHenry ("2001 Form 10-K") . The 2001 Form 10-K reported accounts receivable for 2001 in
the amount of $104,040,000 and selling, general and administrative expenses in the amount o f
$182,972,000. The Company's reported results, in relevant part, were as follows :
$'000 Year EndedDecember 31, 200 1
Net Sales $508,05 3
Gross profit $267,185
Income from Operations $35,08 9
Net Loss $(8,883)
Basic EPS $(0.73)
Diluted EPS $(0.73)
Accounts Receivable $104,040
Allowance $17,62 5
Total Current Assets $195,887
Total Assets $699,907
81 . In the 2001 Form 10-K, the Company stated that "[o]ur analysis and discussion o f
our financial condition and results of operations are based upon our Consolidated Financia l
Statements that have been prepared in accordance with generally accepted accounting principle s
in the United States (`U .S. GAAP') . "
82 . The 2001 Form 10-K included a letter from Hanger 's outside auditor,
PricewaterhouseCoopers LLP, which represented that the financial statements contained therein
were prepared and presented in accordance with GAAP and fairly presented the Company' s
results, stating, in relevant part, as follows :
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In our opinion, the consolidated financial statements listed in theindex appearing under Item 14(a)(1) on page 40 present fairly, inall material respects, the financial position of Hanger OrthopedicGroup, Inc . and its subsidiaries at December 31, 2000 and 2001,and the results of their operations and their cash flows for each ofthe three years in the period ended December 31, 2001, i nconformity with accounting principles generally accepted in theUnited States of America .
83. On February 26, 2003, Hanger issued a press release announcing "record sales,
net income and earnings per share" for the year ended December 31, 2002 . The release
reported the Company's results for 2002, in relevant part, as follows :
Net sales for the year ended December 31, 2002, reached a record$525.5 million, an increase of $17 .5 million, or 3 .4%, over theprior year's net sales of $508 .1 million . The sales growth wasprimarily due to a 4 .6% increase in same center sales in theCompany's O&P practices and a 0 .7% increase in outside sales bythe Company's distribution business, offset by a 0 .9% reduction insales due to the sale of SOGI, the Company's manufacturingoperations, in October of 2001 . Gross profit for the year endedDecember 31, 2002 improved by $17.0 million, or 6.4%, to $284.2million, or 54.1 % of net sales, compared to $267 .2 million, or52.6% of net sales, in the prior year . The gross margin wasfavorably impacted by the increase in net sales along with areduction in the costs of materials and labor due to increasedproductivity in the operation of the O&P practices. The Companyrecorded net income of $23 .6 million for the year ended December31, 2002, compared to a net loss of $8 .9 million in the prior year,an improvement of $32 .5 million . Net income applicable tocommon stock before extraordinary item for the year endedDecember 31, 2002 was $26 .4 million, or $0 .99 per share dilutedshare, a $32.3 million improvement over the $8 .9 million lossrecorded in the prior year . Hanger reported net income applicableto common stock of $18 .4 million, or $0 .86 per share diluted forthe year ended December 31, 2002, compared to a net loss of $13 .7million, or $0.73 per share diluted for the prior year. [Emphasisadded . ]
Commenting on the Company's year-end results for 2002, defendant Sabel stated that th e
Company "continued to improve [its] operations and generated strong cash flow" and that 200 2
"was definitely a win-win year for all of our stakeholders ." [Emphasis added. ]
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84. On March 28, 2003, Hanger filed its Annual Report on Form 10-K for the yea r
ended December 31, 2002, which was signed, inter alia, by defendants Sabel, McHenry and Kirk
("2002 Form 10-K"). The 2002 Form 10-K reported accounts receivable for 2002 in the amoun t
of $107,604,000 and selling, general and administrative expenses in the amount of $189,768,000 .
The Company's reported results, in relevant part, were as follows :
$'000 Year EndedDecember 31, 200 2
Net Sales $525,534
Gross profit $284,162Income from Operations $82,642Net Income $23,570Basic EPS (beforeextraordinary item)
$1 .08
Diluted EPS (befor eextraordinary item)
$0.99
Accounts Receivable $107,604
Allowance $8,649Total Current Assets $192,642Total Assets $712,226
85 . In the 2002 Form 10-K, the Company stated that "[o]ur analysis and discussion of
our financial condition and results of operations are based upon our Consolidated Financia l
Statements that have been prepared in accordance with generally accepted accounting principle s
in the United States (`U.S. GAAP') ." Further, defendants Sabel and McHenry issued separat e
statements, incorporated into the 2002 Form 10-K, stating that the information contained therei n
"fairly presents, in all material respects, the financial condition and results of operations of the
Company." In addition, defendants Sabel and McHenry stated that the 2002 Form 10-K "doe s
not contain any untrue statement of a material fact or omit to state a material fact necessary t o
make the statements made, in light of the circumstances under which such statements were made ,
not misleading with respect to the period covered by this annual report ."
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86. The 2002 Form 10-K included a letter from Hanger's outside auditor ,
PricewaterhouseCoopers LLP, which represented that the financial statements contained therein
were prepared and presented in accordance with GAAP and fairly presented the Company' s
results, stating as follows in relevant part :
In our opinion, the consolidated financial statements listed in theindex appearing under Item 15(a)(1) on page 43 present fairly, inall material respects, the financial position of Hanger OrthopedicGroup, Inc . and its subsidiaries at December 31, 2002 and 2001,and the results of their operations and their cash flows for each ofthe three years in the period ended December 31, 2002, inconformity with accounting principles generally accepted in theUnited States of America .
87 . The statements referenced in ¶¶ 79-86 above were each materially false an d
misleading when made, and were known or recklessly disregarded as such by defendants for the
following reasons :
(a) the Company had improperly recognized and reported revenue forthe years 2001 and 2002, thereby artificially inflating its revenue and net income ;
(b) the Company had materially overstated its accounts receivable andmaterially understated its bad debt expenses and its selling, general andadministrative expenses for the years 2001 and 2002, thereby artificially inflatingassets and net income ;
(c) the Company's reported results for the years 2001 and 2002 werenot prepared in accordance with GAAP and did not fairly present the financialcondition of the Company ;
(d) the Company's reported "record" results were attributable inmaterial part to improper accounting rather than increased demand for its productsand operational improvements ;
(e) the Company suffered from material deficiencies in its internalaccounting controls to properly record accounts receivable, bad debt expense andrevenue, which rendered Hanger's financial reporting unreliable and incorrect ;and
(f) defendants failed to disclose the material adverse factors alleged insubparagraphs (a) through (e) above .
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88. On July 29, 2003, Hanger issued a press release announcing its results for th e
second quarter of 2003, in which it touted "record sales and earnings ," including a 21 %
increase in net income and increases in net sales and in income from operations for the quarter,
and increases in net sales, gross profit and income from operations for the first six months of
2003 . The release reported the Company's results for the second quarter of 2003, and the first
six months of 2003, in relevant part, as follows :
Net sales for the quarter ended June 30, 2003 increased by $5 .8
million, or 4 .4%, to $138 .9 million from $133 .1 million it the prior
year's comparable quarter . The sales growth was primarily the
result of a $2.3 million, or 1.9%, increase in same-center sales in
the Company 's O&P practices and a $1 . 9 million , or 27.5%,
increase in sales of the Company's distribution segment. Gross
profit for the second quarter of 2003 was $73 .5 million, or 52 .9%,
of net sales, compared to $69 .9 million, or 52.5%, of net sales, in
the second quarter of the prior year . The improvement in gross
profit, in both dollars and as a percentage of net sales, was due to
a reduction in labor costs . Income from operations increased by
$2.3 million in the second quarter of 2003 to $25 .2 million from
$22.9 million in the same period of the prior year . The increase in
incomefrom operations is the result of increased net sales and
gross profit .
Net income for the second quarter of 2003 was $9 .4 million, or
approximately $0 .35 per diluted share, on 26 .8 million weighted
average diluted shares outstanding. During the quarter it became
more dilutive to earnings per share to convert the Company'soutstanding preferred stock to common stock, therefore the
preferred stock dividends declared and accretion of $1 .4 million
were not included in the computation, as required by accounting
principles generally accepted in the United States . In the
corresponding period of the prior year, Hanger had net income of
$7.7 million, or approximately $0 .29 per diluted share, on 22 .0
million weighted average diluted shares outstanding .
Net sales for the six months ended June 30, 2003 increased by $8 .5
million, or 3 .3%, to $265 .1 million from $256 .6 million in the prior
year's comparable period . The sales growth was primarily the
result of a $2.6 million or 1.1 % increase in same-center sales in
the Company's O&P practices and a $3.4 million, or 24.9%,
increase in the sales of the Company's distribution segment.Gross profit for the first six months of 2003 was $139 .0 million, or
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52 .4% of net sales, compared to $133 .8 million, or 52 .1%, of net
sales, in the prior year . The improvement in gross profit, in both
dollars and as a percentage of net sales, was due to a reduction in
labor and material costs . Income from operations increased by $4.1
million in the first half of 2003 to $43 .4 million from $39 .3 millionin the same period of the prior year . The increase in income from
operations is the result of increased net sales and gross profit .
[Emphasis added .]
Commenting on these results, defendant Sabel stated : "Sales continued to improve at ou r
patient-care centers during the quarter . We were able to achieve our profitability goals through a
combination of the sales increase, continued control of our costs and the continued exceptiona l
overall performance by our distribution segment . This quarter's results represent record sale s
and earnings ."
89. On August 12, 2003, Hanger filed its quarterly report on Form 10-Q for th e
second quarter of 2003, which was signed , inter alia, by defendants Sabe l and McHenry . The
Company stated that the financial statements accompanying the Form 10-Q were "prepared i n
accordance with Rule 10-01 of Regulation S-X" and that "all adjustments considered necessary
(consisting solely of normal recurring adjustments) for a fair presentation of the consolidate d
financial statements have been included ." Further, defendants Sabel and :McHenry made the
following representations : "Based on my knowledge, this quarterly report does not contain an y
untrue statement of a material fact or omit to state a material fact necessary to make th e
statements made, in light of the circumstances under which such statements were made, no t
misleading with respect to the period covered by this quarterly report ." These defendants further
represented in the Form 10-Q that : "Based on my knowledge, the financial statements , and other
financial information included in this quarterly report, fairly present in all material respects th e
financial condition, results of operations and cash flows of the registrant as of, and for, th e
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periods presented in this quarterly report ." The Company's reported results, in relevant part ,
were as follows :
$'000 Quarter Ended June30, 2003
Net Sales $138,936Gross profit $73,520Income from Operations $25,188Net Income $9,35 3Basic EPS $0.3 9Diluted EPS $0.3 5
Accounts Receivable $111,060Allowance $8,456Total Current Assets $ 186,850
Total Assets $716,805
90. On October 30, 2003, Hanger issued a press release announcing its results for the
third quarter of 2003 and touting growth in EPS of 10% . The release also announced increase s
in net sales, net income, and income from operations , and reported the Company 's results for the
third quarter of 2003, in relevant part, as follows :
Net sales for the quarter ended September 30, 2003 increased by$6.0 million, or 4.5%, to $140.0 million from $134 .0 million in the
prior year's comparable quarter. The sales growth was primarilythe result of a $2.1 million, or 1.7%, increase in same-centersales in the Company 's O&P practices, a $1.6 million, or 19.8%,increase in sales of the Company's distribution segment , with the
net balance coming principally from acquired practices . Grossprofit for the third quarter of 2003 was $75 .2 million, or 53 .7%, ofnet sales, compared to $72 .1 million, or 53 .8%, of net sales, in the
third quarter of the prior year . The improvement in gross profitdollars was due to increased net sales . Income from operations
increased by $1 .5 million in the third quarter of 2003, to $24 .6million from $23 .1 million in the same period of the prior year .
The increase in income from operations is the result of increasednet sales slightly offset by a $1 .2 million increase in selling,general and administrative expenses associated primarily with the
operating expenses of acquired practices, costs associated with theroll-out of our new billing system, and an increase in our
marketing and corporate development activities .
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Based on the above improvements, net income for the third quarterof 2003 increased to $8 .8 million, or approximately $0 .33 perdiluted share . In the corresponding period of the prior year, Hangerhad net income of $7.8 million, or approximately $0 .30 per dilutedshare. [Emphasis added .]
Commenting on these results, defendant Sabel stated :
During the third quarter we were able to generate 10% growth inearnings per share despite continued challenges in our efforts toimprove sales growth . Same-center sales growth wasapproximately 2% for the quarter, but we were able to leverage ourefficient platform and improve our EBITDA margins from 19.0%last year to 19 .6% in 2003 . We increased EPS by 10% over theprior year by maintaining our gross profit margins and reducingour SG&A to 34.2% of sales this year compared to 34 .8% in 2002 .At the same time, we have been making significant investments inmarketing, systems and corporate development that will benefitfuture periods . While we expect fourth quarter to produce the sameor slightly improved sales growth as the third quarter, once we putthe reimbursement and economic issues of 2003 behind us and theinvestments we are making begin to take hold we are optimisticthat sales growth will improve in 2004 .
91 . On November 12, 2003, Hanger filed its quarterly report on Form 10-Q for th e
third quarter of 2003, which was signed, inter alia, by defendants Sabel and McHenry . The
Company stated that the financial statements accompanying the Form 10- .Q were "prepared in
accordance with Rule 10-01 of Regulation S-X" and that "all adjustments considered necessary
(consisting solely of normal recurring adjustments) for a fair presentation of the consolidate d
financial statements have been included ." Further, the Form 10-Q contained the following
representation from defendants Sabel and McHenry made the following representations : "Based
on my knowledge, this quarterly report does not contain any untrue statement of a material fac t
or omit to state a material fact necessary to make the statements made, in light of th e
circumstances under which such statements were made, not misleading with respect to the perio d
covered by this quarterly report ." These defendants further represented in the Form 10-Q that :
"Based on my knowledge, the financial statements, and other financial information included i n
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this quarterly report, fairly present in all material respects the financial condition, results of
operations and cash flows of the registrant as of, and for, the periods presented in this quarterl y
report ." The Company's reported results, in relevant part, were as follows :
$'000 Quarter Ende dSeptember 30, 2003
Net Sales $140,045Gross profit $75,246
Income from Operations $24,592Net Income $8,829
Basic EPS $0.36Diluted EPS $0.33
Accounts Receivable $110,920Allowance $6,83 2Total Current Assets $194,040Total Assets $721,25 5
92 . In a press release , dated February 25, 2004 , Hanger announced a $22 .4 million
increase in its net sales for the year ended December 31, 2003 . The Company reported its results
for 2003 as follows :
Net sales for the year ended December 31, 2003 increased by$22.4 million, or 4 .3%, to $547.9 million from $525 .5 million inthe prior year. The sales growth wasprimarily the result (!f an$8.0 million, or 1.6%, increase in same- center sales in theCompany's O&P practices, and a $5.8 million , or 19.6%,
increase in external sales by the Company's distribution segment,with the net balance coming principally from recently acquiredpractices . Gross profit for the year was $289.5 million, or :52 .8%of net sales, compared to $278 .5 million, or 53 .0% of net sales, inthe prior year . The $11.0 million improvement in gross profit wasdue to increased net sales . Income from operations increased $1 .9million during the year to $84.6 million from $82 .6 million in the
prior year. Selling, general and administrative expenses increased
as the result of the following : (i) a $5 .7 million increase in salaries,travel, and selling expense primarily associated with staffing the
Company's marketing initiative, corporate governance costs, andstaffing related to recently acquired practices ; (ii) a $1 .7 million
increase in bad debt expense due to the increase in net sales which
was virtually unchanged as a percentage of sales ; and (iii) S2 . 7
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million in increased rent and occupancy costs associated
principally with acquired facilities . Income from operations was
further affected by a $0.8 million increase in depreciation and
amortization due to the roll-out of OPS . [Emphasis added . ]
93 . The 2003 Form 10-K repo rted accounts receivable for 2003 in the amount of
$116, 479,000 and selling, general and administrative expenses in the amount of $194,473,000 .
The Company' s Consolidated Bal ance Sheet for the year was repo rted as follows :
$'000 Year Ende dDecember 31, 2003
Net Sales $547,903Gross profit $289,520
Income from Operations $84,570
Net Income $16,239Basic EPS $0.42
Diluted EPS $0.39
Accounts Receivable $116,479Allowance $3,875Total Current Assets $211,393Total Assets $740,364
94. In the 2003 Form 10-K, the Company stated that "[o]ur analysis and discussion o f
our financial condition and results of operations are based upon our Consolidated Financia l
Statements that have been prepared in accordance with generally accepted accounting principle s
in the United States ." Further, defendants Sabel and McHenry issued separate statements ,
incorporated into the 2003 Form K, stating that the information contained in the 2003 Form 10- K
"fairly presents, in all material respects, the financial condition and results of operations of the
Company." Defendants Sabel and McHenry further represented that the Form 10-K "does no t
contain any untrue statement of a material fact or omit to state a material fact necessary to mak e
the statements made, in light of the circumstances under which such statements were made, no t
misleading with respect to the period covered by this annual report . "
-41-
95 . The 2003 Form 10-K included a letter from Hanger 's outside auditor ,
PricewaterhouseCoopers LLP, which represented that the financial statements contained therein
were prepared and presented in accordance with GAAP and fairly presented the Company' s
results, stating, in relevant part, as follows :
In our opinion, the consolidated financial statements listed in theindex appearing under Item 15(a)(1) present fairly, in all materialrespects, the financial position of Hanger Orthopedic Group, Inc .and its subsidiaries at December 31, 2003 and 2002, and the resultsof their operations and their cash flows for each of the three yearsin the period ended December 31, 2003, in conformity withaccounting principles generally accepted in the United States ofAmerica .
96. On April 28, 2004, Hanger issued a press release announcing its results for th e
first quarter of 2004 as follows :
Net sales for the three months ended March 31, 2004 increased by
$5 .5 million, or 4 .4%, to $131 .6 million from $126 .1 million in the
prior year's first quarter . The net sales growth was primarily due
to net sales of acquired O&P practices and a 12 . 9% increase inthe external sales of the Company 's distribution segment , reduced
by a 0.8% decrease in same center sales . Gross profit for the first
quarter of 2004 was $66 .2 million, or 50 .3% of net sales, compared
to $65.4 million, or 51 .9% of net sales, in the prior year . The
improvement in gross profit dollars was the result of the 4.4%
increase in net sales and the decrease, as a percentage of net sales,
was due to an increase in labor and material costs . Labor costsincreased as a percentage of net sales due to a combination of the
impact of annual salary increases effective January 1, 2004 and a
0.8% decrease in same center sales . Selling, general and
administrative expense increased by $2 .4 million due to increased
expenditures quarter-over-quarter on corporate governance, thebilling system (OPS) rollout, our sales growth initiatives, expenses
of acquired entities and the effect of the annual salary increases,
effective January 1, 2004, on salary expense and the related
benefits. Depreciation and amortization increased by $0 .8 million
because the new billing system was placed in service and due to
the rollout of Insignia . Interest expense decreased by $1 .0 million
due to interest savings generated by the refinance of theSubordinated Notes with the new "Term Loan B" in the fourth
quarter.
-42-
Net income applicable to common stock and per diluted share forthe first quarter of 2004 was $3 .6 million, or approximately $0 .16per diluted share, a decrease of $0 .5 million and $0 .03 ,respectively, from the comparable period last year. [Emphasisadded. ]
Commenting on these results, defendant Sabel stated in the release : "We believe that our effort s
and investments that have been made thus far will provide for long-term gain in the future . "
[Emphasis added. ]
97. On May 10, 2004 Hanger filed its quarterly report on Form 10-Q for the firs t
quarter of 2004, which was signed, inter alia, by defendants Sabel and McHenry . The Compan y
stated that the financial statements accompanying the Form 10-Q were "prepared in accordanc e
with Rule 10-01 of Regulation S-X" and that "all adjustments considered necessary (consisting
solely of normal recurring adjustments) for a fair presentation of the consolidated financial
statements have been included ." Further, defendants Sabel and McHenry made the following
representations : "Based on my knowledge, this quarterly report does not contain any untru e
statement of a material fact or omit to state a material fact necessary to make the statement s
made, in light of the circumstances under which such statements were made, not misleading with
respect to the period covered by this quarterly report ." These defendants further represented
that: "Based on my knowledge, the financial statements, and other financial information included
in this quarterly report, fairly present in all material respects the financial condition, results of
operations and cash flows of the registrant as of, and for, the periods presented in this quarterly
report ." The Form 10-Q stated the Company's results, in relevant part, as follows :
-43-
$'000 Quarter Ende dMarch 31, 2004
Net Sales $131,609
Gross profit $66,209
Income from Operations $15,761
Net Income $4,536
Basic EPS $0.1 7Diluted EPS $0.1 6
Accounts Receivable $116,11 4
Allowance $4,900Total Current Assets $201,026Total Assets $747,76 1
98. The statements referenced above in ¶¶ 88-97 were each materially false and
misleading when made, and were known or recklessly disregarded as such by defendants for al l
the reasons alleged in ¶ 87 above, and for the following additional reasons :
(a) defendants failed to disclose the material adverse fact that it hadengaged , and continued to engage in the insurance billing fraud alleged above in¶¶ 51-77;
(b) the Company had materially overstated its accounts receivable andmaterially understated it bad debt expense and selling, general and administrativeexpenses, and had improperly recognized and reported revenue that was th eproduct of the fraudulent billing practices alleged above in ¶¶ 51-77, therebyartificially inflating its assets ;
(c) the Company's reported increases in sales, income, gross profitand EPS were in substantial part the result of the fraudulent billing practicesalleged above in ¶¶ 51-77 ;
(d) the Company suffered from material deficiencies in its internalaccounting and financial controls, which rendered Hanger's financial reportingunreliable and incorrect ;
(e) the Company suffered from material deficiencies in its internalcompliance controls, including inadequate auditing and inadequate supervision ofits patient care facilities to ensure compliance with federal, state, and localregulations and the requirements of private insurers ; and
(f) defendants failed to disclose material adverse facts alleged insubparagraphs (b) through (e) above .
-44-
THE TRUTH CONCERNING HANGER'S BILLING FRAUD B EGINS TO EMERGE
99. In the 11 p.m. news on June 14, 2004, WNBC aired a story that began as follows :
SUE SIMMONS, co-anchor :
Prescription for fraud . A whistleblower says her company isstealing hundreds of thousands of dollars of taxpayer dollars . ANewschannel 4 investigation [ . . . ]
100 . Simmons, with her co-anchor Chuck Scarborough, and investigative reporter Ti m
Minton, went on to report that Kendall McDaniel, a Hanger employee who was in charge o f
processing patients' bills, alleged that "thousands of patient files are forged or non-existent, non e
of which she claims stops the company from billing taxpayers for medical devices that may o r
may not have been delivered ." The news segment continued as follows :
Ms. KENDALL McDANIEL ( Hanger Employee ) : They willcome in , with say, a prescription for shoes and they will either getthe shoes , but then the insurance company will be billed for shoesand additional items . And then I'm saying that there may be nopatient at all, just a fake name .
MINTON : The rules for reimbursement by Medicare, Medicaid,and insurance companies are strict and specific . A prescriptionsigned by a doctor is required, and so are notes that justify whypart icular equipment is necessary , given the patient's diagnosisand condition . McDaniel says blank Elmhurst Hospita lprescription pads and official insurance company documents arekept at the Hanger office where she says she has seen a managerfill them out .
Ms. McDANIEL: Not only prescriptions, letters of medicalnecessities, Medicare supplier standards . Things that need to be inthe chart in order to bill out to Medicare are just signed as if adoctor was signing them on a day-to-day basis .
MINTON: In a statement, the New York City Health andHospital's Corporation says, "this matter appears to involve thetheft and fraudulent use of hospital prescription pads without anyknowledge of Elmhurst Hospital or the physicians whose nameswere used ."
-45-
The whistleblower has hired an attorney. She says to make sureshe can keep her job and follow the law . Kenneth Mollins sent aletter to federal and state prosecutors, requesting they reviewHanger's files .
MINTON: Hanger's response, "the company is adamant about
compliance . We're conducting an internal audit . If there issomething that is done inappropriately , there will be strong andimmediate action . "
But the results of an internal audit conducted last summer andobtained by Newschannel 4, show that all 15 files checked at thattime had problems complying with the law ranged from noprescriptions to no justifying notes .
Overall, the company's own auditor gave a failing grade, 50 out of100 with 80 considered compliance . In a follow-up this February,seven months later, the auditor sent an e-mail to company officialswarning, "I am still very concerned about the integrity of thedocuments I've receive . There remain numerous altere ddocuments ."
Ms. McDANIEL: I worked for Worldcom . I got fired or laid offdue to fraud. The biggest fraud in the history of the country . I'vebeen through this, and I don't want to have it happen again . MaybeI can stop it and tell people, and maybe somebody else will comeforward .
MINTON: Kendall McDaniel has been placed on administrativeleave with pay until Hanger completes its inte rnal audit . Thecompany says it has reassigned a m anager implicated in forgedprescriptions and other alleged fraud to a job where he can be moreclosely supervised . Sue, Chuck, more to come on this .
101 . In a press release issued the following day, the Company attempted to downplay
the billing fraud. In the release, the Company referred only to "allegations of billing
irregularities" (emphasis added), and did not describe the nature or extent of the fraud . Nor did
defendants admit that they knew - by virtue of the results of the July and November Audits ,
Hanger's failure to resolve the deficiencies identified in those audits, the expressed concern of
Hanger's Compliance Auditor that illegal activity was being committed by Hanger employees ,
and the Office Administrator's whistleblower call to the Company's Compli ance Hotline - that
-46-
the facts presented in the WNBC News Report were more than mere "allegations" and that
Hanger was aware of the truth of the facts in that report . The release stated as follows :
Hanger Orthopedic Group has been made aware of alleged billingirregularities by one clinician in one of the company's 608 patientcare centers . An employee in the office reported the allegedirregularities on the Company's Compliance Hot Line - a
confidential communications vehicle that encourages individuals tocome forward with any concerns or suspicions regarding potential
violations of the Company's processes or policies . The Company,in conjunction with its outside counsel, has initiated a prompt and
thorough investigation of these allegations .
Ivan R. Sabel, Chairman and CEO of Hanger Orthopedic Group
said `Hanger Orthopedic Group has an active internal audit team
that reports to the Audit Committee of its Board of Directors and is
committed to maintaining the highest standards of integrity and
compliance . We take this matter very seriously . We are expending
all necessary resources to bring this matter to an accurate and swift
conclusion . '
Hanger, however, did not, and to this day has not, denied any of the allegations of billing fraud a t
the West Hempstead Facility.
102 . As a result of the disclosures on June 14 and 15, 2004 , the price of H anger shares
declined substantially . The Company's shares had opened on June 14, 2004 at $15 .75 per share .
The following day, after trading in the Company's shares was halted by the NYSE due to
unusually heavy volume, Hanger shares fell to a closing price of $12 .75 per share on heavy
volume of 2.4 million shares . Thus, in the two days following the initial revelations about the
Company's billing fraud, the Company's stock price decreased by 19 percent .
103 . On June 18, 2004 the Company announced that it had received a subpoena from
the U.S. Attorney's Office for the Eastern District of New York on June 17 , 2004 requesting that
the Company produce documents relating to the allegations of billing fraud, and seeking
information conce rn ing 14 of the Company's facilities located in New York State., At the same
-47-
time, the Company also announced that the SEC also had requested information from the
Company relating to the billing fraud allegations .
104 . The June 18, 2004 announcement further weakened Hanger's reputation and
further eroded confidence in Hanger 's integrity . The announcement suggested to the marke t
that, far from being an isolated incident at only one of Hanger's facilities, the billing fraud wa s
occurring at several other Hanger facilities, which further jeopardized Hanger's status as a n
approved O&P provider under Medicare, Medicaid and private insurance programs and furthe r
exposed Hanger to penalties and liability . For example, a Lehman Brothers analyst report issue d
on June 21, 2004 - after the Company's disclosure of the government investigations - state d
that :
The investigation appears to be more broad based than originallyassumed, with the US Attorney's Office requesting documentsregarding these issues from 14 facilities across downstate NewYork (vs. the one facility originally cited) . In addition , the scopeof the investigation may be wider than originally thought . TheSEC also has requested information from HGR relating to theallegations . [Emphasis added . ]
105 . As a result of the Company's June 18, 2004 disclosure concerning the
government investigations, the Company's shares experienced a further sharp decline . Hanger's
stock price fell from an opening price of $12 .00 on Friday, June 18, 2004 to a closing price o f
$9.34 on the next trading day, Monday June 21, 2004 - a two-day drop of more than 22 % .
THE TRUTH CONCERNING HANGER'S MATERIALLY FALSE FINANCIALSTATEMENTS BEGINS TO EMERGE
106. On August 9, 2004, Hanger issued a press release announcing that it would delay
its earnings release for the second quarter of 2004 scheduled for August 9, 2004, until August 16 ,
2004. The Company claimed that the delay was necessary in order to "complete certai n
accounting reviews ." The press release, in relevant part, stated :
-48-
Hanger Orthopedic Group, Inc. Announces Delay of ItsEarnings Release and Investor's Conference Call
BETHESDA, Md ., Aug. 9 /PRNewswire-FirstCall/ -- Hanger
Orthopedic Group, Inc . (NYSE : HGR) today announced the delay
of its earn ings release scheduled for after the close of the market
on August 9, 2004, until after the close of the market on August
16, 2004, and the investor's conference call scheduled for August10, 2004, until August 17, 2004 in order to complete certain
accounting reviews .
107. On August 10, 2004, Hanger filed a Form 12b-25 Notice of Late Filing, signed b y
defendant McHenry, stating that it was delaying the filing of its Form 10•-Q for the second
quarter of 2004 . The Company stated that it was unable to complete the financial review of its
quarterly results in a timely fashion "in large part due to the substantial time and efforts
expended by management to cooperate with the internal investigation of certain alleged billing
discrepancies . "
108. As reported by TheStreet .com on August 11, 2004, "[s]hares in Hange r
Orthopedic Group (NYSE : HGR - News) plunged in heavy trading Wednesday in the wake of the
company's decision to postpone its earnings report to `complete certain accounting reviews ."'
As a result of Hanger's August 9 and August 10, 2004 announcements, Hanger's shares fell from
a high of $9 .85 per share on August 9, 2004 to a low of $4 .27 per share on August 12, 2004, for
a three day decline of over 50%. Thus, by August 12, 2004, Hanger's share price had fallen over
72% from its opening price on June 14, 2004, before the WNBC New Report, and over 77%
from its Class Period high of $19 .25 on January 22, 2004 .
109. On August 16, 2004, the Company issued a press release announcing that it was
restating its previously issued balance sheet as of December 31, 2003 and . the statements of
operations and cash flows for the six months ended June 30, 2003 to reflect "a correction of an
error that led to the overstatement of recorded accounts receivable and an equal understatemen t
-49-
of had debt expense ." According to the release , the Company's past financial statements had
understated selling, general and administrative expense by $0 .3 million for the quarter ende d
March 31, 2004, $1 .0 million for the year ended December 31, 2003 and $2 .5 million for the
years prior to 2003 . In the same release , Hanger claimed that the "discrepancy" in its financia l
statements was discovered during the completion of the roll-out of its new billing and cash
collection system, OPS. According to the Company's release, the new OPS system gave th e
Company "better visibility over its accounts receivable and improved controls over its inter-
branch cash collection activity," and led the Company to determine that "certain receivable s
were uncollectible." The August 16, 2004 press release, in relevant part ., stated :
Restatement of Accounts Receivabl e
The previously issued balance sheet as of December 31, 2003 andthe statements of operations and cash flows for the six monthsended June 30, 2003 have been restated to reflect a correction of anerror that led to the overstatement of recorded accounts receivableand an equal understatement of bad debt expense . The errorresulted in an understatement of selling, general and administrativeexpense of $0 .3 million for the quarter ended March 31, 2004, $1 .0million for the year ended December 31, 2003 and $2 .5 million forthe years prior to 2003 . In the year ended December 31, 2003,selling general and administrative expense for the three monthsended June 30, 2003 and March 31, 2003 was restated andincreased by $0 .2 million and $0 .3 million, respectively .
The discrepancy was discovered during the preparation of our June30, 2004 financial statements . By June, we had substantiallycompleted the roll-out of our new billing and cash collectionsystem (OPS), which aided in the discovery of the discrepancy .The OPS system replaced more than 15 different billing and cashcollection platforms previously utilized in our over 600 practices tobill and collect for our products and services . The new systemprovides the Company better visibility over its accounts receivableand improved controls over its inter-branch cash collectio nactivity. After a successful pilot test, the Company commenced theinstallation of this system in September 2003 and by the end ofJune 2004 had installed the system in all practices except thepatient care centers of two recent acquisitions and three centra l
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billing offices, which require an enhanced multi-user version of thesystem that has not yet completed testing .
The conversion to the OPS single billing and cash collectionplatform permitted reconciliation of inter-branch cash collectionactivity and we determined that certain receivables wereuncollectible . The Company, with the concurrence of itsindependent registered public accounting firm, concluded that thisadjustment should be reported as a correction of an error topreviously issued financial statements . The release of our secondquarter results and the filing of form 10-Q for the quarter and sixmonths ended June 30, 2004 was delayed while we completed ananalysis of the periods affected by the error. The Company alsowas delayed in filing because it was unable to complete thefinancial review of its quarterly results in a timely fashion due tothe substantial time and efforts expended by management tocooperate with the independent investigation of the allegationsconcerning improper billing activities at our West Hempsteadbranch, discussed in our press release dated August 9, 2004 . Weintend to file within a reasonable period of time an amendment toour 2003 Form 10-K report .
110 . On September 15, 2004, the Company filed anAmendment to its 2003 Form 10-
K ("Restated 2003 Form 10-K"), which restated the Company's financial statements as o f
December 31, 2003, 2002 and 2001 and for the years then ended . Specifically, the Company
restated its consolidated balance sheets as of December 31, 2003 and 2002 and its consolidated
statements of operations and cash flows for the years ended December 31, 2003, 2002 and 2001 ,
as follows :
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$'000 SG&A NetIncome /
(Loss )BeforeTaxes
Basic EPS DilutedEPS
Account sReceivable
Tota lCurrentAssets
2003
PreviouslyReported
194,473 28,210 0.42 $0.39 116,479 211,39 3
Adjustment 1,043 (1,043) (0 .03) $(0 .02) (3,543) (2,016)Restated 195,516 27,167 0 .39 $0.37 112,936 209,377
2002PreviouslyReported
184,072 39,642 0.94 $0.86 107,604 192,642
Adjustment 1,015 (1,015) (0.03) $(0.03) (2,500) (1,423)Restated 185,087 38,627 0.91 $0.83 105,104 191,21 9
2001PreviouslyReported
178,571 (7,976) (0 .73) $(0 .73) - -
Adjustment 1,485 (1,485) (0.04) $(0.04) - -Restated 180,056 (9,461) (0.77) $(0.77) - -
111 . The Restated 2003 Form 10-K also disclosed for the first time the deficiencies in
the Company's internal controls , stating :
During the preparation of our June 2004 financial statements, itbecame apparent that, with the enhanced visibility provided by ournew billing and cash collection system (O/P/S) that our previouslyreported accounts receivable balance at March 31, 2004 wasoverstated by $3 .8 million. The error has been corrected andfinancial statements have been restated as appropriate .
The Company is continuing its evaluation of its internal controls inlight of the standards adopted by the PCAOB . In the course of itsongoing evaluation, management has identified certaindeficiencies which the Company is addressing. Areas requiringimprovement include documentation of controls and recording oftransfers between patient-care centers . Management will considerthese matters when assessing the effectiveness of the Company's
internal control over financial reporting at December 31, 2004 .112. jin jtd b jr 15, 2004, the Company filed an Amendment to its quarterl y
report for the first quarter of 2004, signed by defendant McHenry, which restated the Company' s
financial statements as of March 31, 2004, and for the quarters ended March 31, 2004 and 2003 .
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The reported effects of the restatement on the Company's previously issued financial result s
were as follows :
$'000 Quarter Ende dMarch 31, 2004 (aspreviously reported)
Adjustments Quarter EndedMarch 31, 200 4
(Restated )
SGA $47,134 $257 $47,39 1
Net IncomeBefore Taxes
$7,688 $(257) $7,43 1
Basic EPS $0.17 $(0.01) $0.1 6Diluted EPS $0.16 $(0.01) $0.1 5
AccountsReceivable
$116,114 $(3,800) $112,314
Total CurrentAssets
$201,026 $(2,162) $198,864
Total Assets $747,761 $(2,162) $745,599
113 . By the time the Company issued its August 16, 2004 announcement that it woul d
restate its financial results, and its September 15, 2004 restated financial statements, the market
had already anticipated the effect of this news on the value of Hanger shares by virtue o f
Hanger's August 9 and 10, 2004 disclosures, causing a 50% decline in Hanger's shares by
August 12, 2004. Given that by August 12, 2004, the market had already factored into Hanger' s
share price the effect of an anticipated restatement of Hanger's financial results, Hanger's shar e
price remained relatively unchanged in the days following the Company's August 16, 200 4
announcement and its September 15, 2004 restatements .
HANGER'S MATERIALLY FALSE FINANCIAL STATEMENTSVIOLATED GAAP AND SEC REGULATION S
114. Defendants represented that Hanger's Class Period financial statements wer e
prepared in accordance with GAAP. As set forth herein , these representations were materiall y
false and misleading because defendants caused Hanger to issue financial statements tha t
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misrepresented and/or artificially and improperly inflated the Company's operating results
during the Class Period .
115. As investors came to learn on August 16, 2004, Hanger had been artificially
inflating its financial results and condition throughout the Class Period by overstating its
accounts receivable, revenue and net income and understating its bad debt expense and selling,
general and administrative expenses . Because of these accounting improprieties, Hanger's
financial statements were, contrary to its express representations contained in its quarterly and
annual reports, not prepared in accordance with GAAP or applicable SEC regulations .
116. GAAP are those principles recognized by the accounting profession as th e
conventions, rules, and procedures necessary to define accepted accounting practices at a
particular time . As set forth in Financial Accounting Standards Board ("FASB") Statements of
Concepts ("Concepts Statement") No . 1, one of the fundamental objectives of financial reporting
is that it provide accurate and reliable information concerning an entity's financial performance
during the period being presented . Concepts Statement No. 1, paragraph 42, states :
Financial report ing should provide information about anenterprise ' s financial performance during a period . Investors andcreditors often use information about the past to help in assessingthe prospects of an enterprise . Thus , although investment andcredit decisions reflect investors ' and creditors ' expectations aboutfuture enterprise performance , those expectations are commonlybased at least part ly on evaluations of past enterprise perform ance .
Management is responsible for preparing financial statements that conform with GAAP. As
noted by the AICPA professional standards :
financial statements are management's responsibility . . . .[M]anagement is responsible for adopting sound accountingpolicies and for establishing and maintaining internal control thatwill, among other things, record, process, summarize, and reporttransactions (as well as events and conditions) consistent withmanagement's assertions embodied in the financial statements .The entity's transactions and the related assets, liabilities an d
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equity are within the direct knowledge and control of management. . . . Thus, the fair presentation of financial statements inconformity with Generally Accepted Accounting Principles is animportant and integral part of management's responsibility .
117. As set forth in Financial Accounting Standards Board ("FASB") Statement of
Concepts ("Concepts Statement") No . I ("CON 1), Objectives of Financial Reporting by Busines s
Enterprises (November 1978), one of the fundamental objectives of financial reporting is that it
provides accurate and reliable information concerning an entity's financial performance durin g
the period being presented . CONI provides, in pertinent part ,
Financial reporting should provide information about anenterprise's financial performance during a period . Investors andcreditors often use information about the past to help in assessingthe prospects of an enterprise . Thus, although investment andcredit decisions reflect investors' and creditors' expectations aboutfuture enterprise performance, those expectations are commonlybased at least partly on evaluations of past enterprise performance .
118 . Regulation S-X (17 C .F.R. §210.4-01(a)(1)) states that financial statements filed
with the SEC which are not prepared in compliance with GAAP are presumed to be misleading
and inaccurate . Regulation S-X requires that interim financial statements must also comply wit h
GAAP, with the exception that interim financial statements need not include disclosures whic h
would be duplicative of disclosures accompanying annual financial statements . 17 C .F .R.
§21 0. 10-0 1 (a) .
119. During the Class Period, defendants caused Hanger to issue financial statement s
in violation of GAAP and SEC rules and regulations, by failing to properly repo rt its results for
the fiscal years ended December 31, 2003, 2002 and 2001 and the quarter ended March 31, 2004 .
Specifically, Defendants manipulated Hanger's financial statements by :
(a) failing to properly account for accounts receivable and bad debtexpense, thereby artificially overstating assets and net income ;
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(b) failing to properly report and record revenue, thereby overstating
revenue and net income; and
(c) failing to properly maintain an adequate system of internal control,thereby rendering Hanger's financial reporting unreliable ,and incorrect .
Hanger's Failure to Properly Account for Accounts Receivable and Bad Debt Expe nse
120 . GAAP considers "[t]he conditions under which receivables exist usually involve
some degree of uncertainty about their collectibility, in which case a contingency exists . . . .
[Contingency is defined as an existing condition, situation, or set of circumstances involving
uncertainty as to possible gain or loss to an enterprise that will ultimately be resolved when one
or more future events occur or fail to occur . . . .] ." Losses from uncollectible receivables shall
be accrued when both conditions in paragraph 8 of SFAS No. 5 are met . Those conditions may
be considered in relation to individual receivables or in relation to groups . of similar types of
receivables . If the conditions are met, accrual shall be made even though the particular
receivables that are uncollectible may not be identifiable . SFAS No. 5 ¶ 22 .
121 . Additionally, GAAP provides that an estimated loss from a loss contingency, such
as the collectibles of receivables , "shall be accrued by a charge to income " if. (i) information
available prior to issuance of the financial statements indicated that it is probable that an asset
had been impaired or a liability had been incurred at the date of the financial statements ; and (ii)
the amount of the loss can be reasonably estimated . SFAS No. 5 ¶ 8. SFAS No . 5 also requires
that financial statements disclose contingencies when it is at least reasonably possible (e .g., a
greater than slight chance) that a loss may have been incurred . The disclosure shall indicate the
nature of the contingency and shall give an estimate of the possible loss, a range of loss or state
that such an estimate cannot be made .
122. The SEC considers the disclosure of loss contingencies to be so impo rtant to an
informed investment decision that it promulgated Regulation S-X, which provides tha t
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disclosures in interim period financial statements may be abbreviated and need not duplicate the
disclosure contained in the most recent audited financial statements, except that, "where material
contingencies exist, disclosure of such matters shall be provided even though a significant
change since year end may not have occurred ." 17 C .F .R. § 210.10-01 .
123. Accounting Research Bulletin ("ARB") No . 43 Chapter 3. Section 9 provides that
the objective of providing for reserves against receivables is to assure that, "[a]ccount s
receivable net of allowances for uncollectible accounts . . . are effectively stated as the amount of
cash estimated as realizable . "
124 . In addition , CONS states, "[a]n expense or loss is recognized if it become s
evident that previously recognized future economic benefits of an asset have been reduced o r
eliminated . . . . "
125. Despite these requirements, as alleged in detail above, the Company's financia l
statements during the Class Period failed to properly reflect the Company's bad debt expense an d
accounts receivable as required by GAAP . Instead, the Company ' s reported results included bad
debt expense which was artificially understated by $3 .5million and accounts receivable which
was artificially overstated by $3 .5 million for the three years 2001, 2002 and 2003 .
Hanger's Improper Accounting and Reporting of Revenu e
126. GAAP provides that revenue should not be recognized until it is realized o r
realizable and earned . FASB Concepts Statement No. 5, Recognition and Measurement in
Financial Statements of Business Enterprises ("CON 5") (December 1984), ¶¶ 83-84;
Accounting Research Bulletin No . 43, Restatement and Revision of Accounting Researc h
Bulletins (June 1953) Chapter IA ¶1 ; Accounting Principles Board Opinion No. 10 Omnibu s
Opinion, (December 1966), ¶12 . The conditions for revenue recognition ordinarily are met whe n
persuasive evidence of an arrangement exists, delivery has occurred or services have bee n
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rendered, the seller price to the buyer is fixed or determinable, collectibility is reasonabl y
assured, and the seller has substantially accomplished what it must do to be entitled to th e
benefits represented by the revenues . Staff Accounting Bulletin No . 101 Revenue Recognition
in Financial Statements ("SAB 101") (December 1999) and CON 5 ¶ 83 .
127 . Hanger's audited 2003 Form 10-K disclosed the following, policy of accounting
for revenue :
Revenues on the sale of orthotic and prosthetic devices andassociated services to patients are recorded when the device isaccepted by the patient, provided that (i) there are no uncertaintiesregarding customer acceptance ; (ii) persuasive evidence of anarrangement exists ; (iii) the sales price is fixed and determinable ;and (iv) and collectibility is deemed probable . Revenue is recordedat its net realizable value taking into consideration allgovernmental and contractual adjustments and discounts .
128. Hanger's financial statements during the Class Period were materially false an d
misleading and in violation of GAAP and the Company's own disclosed accounting policie s
because it improperly booked revenue by, inter alia, forging prescriptions and other document s
necessary for obtaining reimbursement from insurers (including Medicare and Medicaid) ,
charging insurers for items or services that were not prescribed for, or not provided to patients ,
misrepresenting to insurers the type of item , or the scope of the services , provided to patients,
and improperly billing for items before they were even provided to patients - all as allege d
more fully in ¶¶ 51-77 above . As such, Hanger improperly booked revenue that it knew, o r
recklessly disregarded was not realized or not realizable and that was subject to non-payment o r
recoupment by third party payors .
Hanger's Failure to Maintain an Adequate System of Internal Control s
129 . Section 13(b)(2)(B) of the Exchange Act requires every issuer that has securitie s
registered pursu ant to Section 12 of the Exchange Act to: (A) make and keep books, records and
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accounts which, in reasonable detail, accurately and fairly reflect the transactions and disposition
of the assets of the issuer; and (B) devise and maintain a system of internal accounting controls
sufficient to reasonably assure, among other things, that transactions are recorded as necessary to
permit preparation of financial statements in conformity with GAAP . These provisions require
an issuer to employ and supervise reliable personnel, to maintain reasonable assurances that
transactions are executed as authorized, to properly record transactions on an issuer's books and,
at reasonable intervals, to compare accounting records with physical assets .
130. The Company suffered from a chronic and systematic breakdown of its internal
accounting controls to properly record accounts receivable, bad debt expense and revenue and
which rendered Hanger's financial reporting unreliable and incorrect, resulting in materially false
and misleading financial statements . In particular :
(a) the Company maintained insufficient controls relating to thedocumentation of controls including the documentation of controls relating topatient-care centers as disclosed in Hanger's Restated 2003 Form I OK/A;
(b) the Company maintained insufficient controls relating to therecording of transfers between patient-care centers as disclosed in Hanger'sRestated 2003 Form 10K/A;
(c) the Company's control environment was such that patient carecenters generally operated in an uncontrolled and unsupervised manner;
(d) the Company maintained insufficient internal compliance controls,including inadequate auditing and supervision of its patient care facilities toensure compliance with federal, state, and local regulation and the requirementsof private insurers ; and
(e) the Company employed, and failed to adequately supervise,personnel in key management and oversight positions, such as Donna Crouse,David Zwicker, Jerry Johnson and Jerry Ritieni, that it knew to be unreliable .
131 . As disclosed in the Hanger's Restated 2003 Form 10-K/A :
During the preparation of our June 2004 financial statements, itbecame apparent that, with the enhanced visibility provided by our
new billing and cash collection system (O/P/S) that our previousl y
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reported accounts receivable balance at March 31, 2004 wasoverstated by $3 .8 million . The error has been corrected andfinancial statements have been restated as appropriate .
The Company is continuing its evaluation of its internal controls inlight of the standards adopted by the PCAOB . In the course of itsongoing evaluation, management has identified certaindeficiencies which the Company is addressing. Areas requiringimprovement include documentation of controls and recording oftransfers between patient-care centers . Management will considerthese matters when assessing the effectiveness of the Company'sinternal control over financial reporting at December 31, 2004 .[Emphasis added . ]
132. Defendants knowingly or recklessly failed to implement and maintain adequat e
internal control systems in a manner that would ensure compli ance with GAAP, resulting i n
materially false and misleading financial statements throughout the Class Period .
Hanger 's False and Misleading Class Period Financial Statements Were Materia l
133 . In view of "the potential dilution of public confidence in financial statement s
resulting from restating the financial statements of prior periods," GAAP provides that a
retroactive restatement of financial statements, like Hanger's, is reserved for material accounting
errors that existed at the time the financial statements were prepared . AP1 3 Opinion No . 20 ,
Accounting Changes 18, 27, 34-38 (July 1971) . Because GAAP allows only for correction of
errors that are "material," by restating its financial statements, Hanger admitted the materiality o f
the errors in its previously issued financial statements .
Hanger's Violations of SEC Regulation s
134. Item 7 of Form 10-K and Item 2 of Form 10-Q, Management Discussions an d
Analysis of Financial Condition and Results of Operations ("MD&A") require the issuer t o
furnish information required by Item 303 of Regulation S-K [17 .C.F.R.229 .303] . In discussing
results of operations, Item 303 of Regulation S-K requires the registrant to :
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[d]escribe any known trends or uncertainties that have had or thatthe registrant reasonably expects will have a material favorable orunfavorable impact on net sales or revenues or income fromcontinuing operations .
135 . In addition, the SEC in its May 1989 Interpretive Release No . 34-2683 1, has
indicated that registrants should employ the following two step analysis in determining when a
known trend or uncertainty is required to be included in the MD&A disclosure pursuant to Ite m
303 of Regulation S-K :
A disclosure duty exists where a trend, demand, event oruncertainty is both presently known to management and isreasonably likely to have a material effect on the registrant'sfinancial condition or results of operations .
136. Nonetheless, Hanger's Class Period Forms 10-K and 10-Q failed to adequately
disclose the uncertainties associated with accounts receivable, bad debt expense, and revenue i n
violation of SEC regulations, which defendants knew or recklessly disregarded .
Hanger 's Additional GAAP Violations
137. In addition to the violations of GAAP noted above , the Company presented it s
financial results for accounts receivable, bad debt expense and revenue in a manner that als o
violated the following fundamental accounting principles :
(a) The principle that interim financial reporting should be based uponthe same accounting principles and practices used to prepare annual financialstatements (APB No . 28, ¶12) ;
(b) The concept that financial repo rting should provide informationthat is useful to present and potential investors and creditors and other users inmaking rational investment, credit, and similar decisions was violated (ConceptsStatement No. 1, ¶34) ;
(c) The concept that financial reporting should provide informationabout the economic resources of an enterprise, the claims to those resources, andeffects of transactions, events, and circumstances that change resources andclaims to those resources was violated (Concepts Statement No . 1, ¶40) ;
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(d) The concept that financial reporting should provide informationabout how management of an enterprise has discharged its stewardshipresponsibility to owners (stockholders) for the use of enterprise resourcesentrusted to it was violated. To the extent that management offers securities ofthe enterprise to the public, it voluntarily accepts wider responsibilities foraccountability to prospective investors and to the public in general (ConceptsStatement No . 1, ¶50) ;
(e) The concept that financial reporting should provide informationabout an enterprise's financial performance during a period was violated .Investors and creditors often use information about the past to help in assessingthe prospects of an enterprise . Thus, although investment and credit decisionsreflect investors' expectations about future enterprise performance, thoseexpectations are commonly based at least partly on evaluations of past enterpriseperformance (Concepts Statement No . 1, ¶42) ;
(f) The concept that financial reporting should be reliable in that itrepresents what it purports to represent was violated . That information should bereliable as well as relevant is a notion that is central to accounting (ConceptsStatement No . 2, ¶¶58-59) ;
(g) The concept of completeness , which means that nothing is left outof the information that may be necessary to insure that it validly representsunderlying events and conditions was violated (Concepts Statement No. 2, ¶79) ;and
(h) The concept that conservatism be used as a prudent reaction tounce rtainty to try to ensure that unce rtainties and risks inherent in businesssituation are adequately considered was violated . The best way to avoid injury toinvestors is to try to ensure that what is repo rted represents what it purports torepresent (Concepts Statement No. 2, ¶¶95, 97) .
ADDITIONAL SCIENTER ALLEGATION S
138 . As alleged herein, defendants acted with scienter in that defendants knew that th e
public documents and statements issued or disseminated in the name of the Company were
materially false and misleading ; knew that such statements or documents would be issued o r
disseminated to the investing public ; and knowingly and substantially participated or acquiesce d
in the issuance or dissemination of such statements or documents as primary violations of th e
federal securities laws . As set forth elsewhere herein in detail, defendants, by virtue of thei r
receipt of information reflecting the true facts regarding Hanger, their control over, and/o r
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receipt and/or modification of Hanger's allegedly materially misleading misstatements and/o r
their associations with the Company which made them privy to confidential proprietar y
information concerning Hanger, participated in the fraudulent scheme alleged herein .
Defendants were motivated to engage in the fraud alleged herein so that Hanger insiders could
sell their personally held Hanger stock at artificially inflated prices . By virtue of Hanger' s
billing fraud and its improper accounting and dissemination of materially false financia l
statements, defendants' scheme succeeded in artificially inflating the Company's stock pric e
from $8.88 per share on March 12, 2002 the day before the Class Period begins - to a Clas s
Period high of $19 .25 on January 22, 2004 . During the Class Period , defendants Sabel and
McHenry, among other Company insiders , took advantage of the artificial share price inflation
by selling over 40,000 shares of their Hanger common stock at artificially inflated prices, reapin g
gross proceeds in excess of $700 ,000, as follows :
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Individual Defendant Date of Sale No . ofShares
Price/Share Proceed s
Ivan R. Sabe lChairman of the Board andCEO
11/26/03 13,983 $16 .55 $231,418 .65
11/26/03 10,000 $16 .62 $166,200.0011/26/03 7,400 $16 .60 $122,840 .0011/26/03 1,537 $16.63 $25,560 .3 111/26/03 100 $16.56 $1,656.00
Total Sabel ---- J--13,020 S547,674 .96
George E. McHenryCFO and Executive VP
11/7/03 7,200 $16 .40 $118,080 .00
11/7/03 3,800 $16 .39 $62,282.0011/7/03 2,500 $16 .35 $40,875 .0011/7/03 1,300 $16 .45 $21,385 .0011/7/03 900 $16 .38 $14,742 .0011/7/03 600 $16 .36 $9,816.0011/7/03 600 $1660 $9,960.0011/7/03 400 $16.41 $6,564 .0011/7/03 400 $16.43 $6,572.0011/7/03 300 $16.37 $4,911 .0011/7/03 200 $16.31 $3,262.0011/7/03 200 $16.34 $3,268.0011/7/03 200 $16 .54 $3,308 .0011/7/03 200 $16.55 $3,310 .0011/7/03 100 $16.42 $1,642.0011/7/03 100 $16.57 $1,657.00
Total Mcllenrv 11 ,800 $193,554.00
Total Individua lDefendants
44,820 $741,228 .96
Applicability Of Presumption Of Reliance:Fraud-On-The-Market Doctrine
139 . At all relevant times, the market for Hanger's securities was an efficient marke t
for the following reasons, among others :
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(a) Hanger's stock met the requirements for listing, and was listed andactively traded on the NYSE, a highly efficient and automated market ;
(b) As a regulated issuer, Hanger filed periodic public reports with theSEC and the NYSE ;
(c) Hanger regularly communicated with public investors viaestablished market communication mechanisms, including through regulardisseminations of press releases on the national circuits of major newswireservices and through other wide-ranging public disclosures, such ascommunications with the financial press and other similar reporting services ; and
(d) Hanger was followed by several securities analysts employed bymajor brokerage firms who wrote reports, which were distributed to the salesforce and certain customers of their respective brokerage firms . Each of thesereports was publicly available and entered the public marketplace .
140. As a result of the foregoing , the market for Hanger ' s securities promptly digested
current information regarding Hanger from all publicly available sources and reflected suc h
information in Hanger's stock price . Under these circumstances, all purchasers of Hanger' s
securities during the Class Period suffered similar injury through their purchase of Hanger' s
securities at artificially inflated prices and a presumption of reliance applies .
NO SAFE HARBOR
141 . The statutory safe harbor provided for forward-looking statements under certai n
circumstances does not apply to any of the allegedly false statements plea-led in this complaint .
Many of the specific statements pleaded herein were not identified as "forward-lookin g
statements" when made . To the extent there were any forward- looking statements, there were n o
meaningful cautionary statements identifying important factors that could cause actual results t o
differ materially from those in the purportedly forward-looking statements . Alternatively, to the
extent that the statutory safe harbor does apply to any forward-looking statements pleade d
herein, defendants are liable for those false forward-looking statements because at the time eac h
of those forward-looking statements was made, the particular speaker knew that the particula r
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forward-looking statement was false, and/or the forward-looking statement was authorize d
and/or approved by an executive officer of Hanger who knew that those statements were fals e
when made .
FIRST CLAIM
Violation Of Section 10(b) OfThe Exchange Act And Rule 10b- 5
Promulgated Thereunder Against All Defendant s
142 . Plaintiffs repeat and re-allege each and every allegation contained above as i f
fully set forth herein .
143. During the Class Period, Hanger and the Individual Defendants, and each of them ,
carried out a plan, scheme and course of conduct which was intended to and, throughout the
Class Period, did: (a) deceive the investing public , including plaintiffs and other Class members ,
as alleged herein ; (b) artificially inflate and maintain the market price of Hanger's securities ; and
(c) cause plaintiffs and other members of the Class to purchase Hanger's securities at artificiall y
inflated prices . In furtherance of this unlawful scheme, plan and course of conduct, defendants ,
and each of them, took the actions set forth herein .
144. Defendants (a) employed devices, schemes, and artifices to defraud ; (b) made
untrue statements of material fact and/or omitted to state material facts necessary to make th e
statements not misleading; and (c) engaged in acts, practices, and a course of business whic h
operated as a fraud and deceit upon the purchasers of the Company's securities in an effort t o
maintain artificially high market prices for Hanger's securities in violation of Section 10(b) o f
the Exchange Act and Rule I Ob-5 . All defendants are sued either as primary participants in the
wrongful and illegal conduct charged herein or as controlling persons as alleged below .
145 . In addition to the duties of full disclosure imposed on defendants as a result of
their making of affirmative statements and reports, or participation in the making of affirmativ e
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statements and reports to the investing public, defendants had a duty to promptly disseminat e
truthful information that would be material to investors in compliance with the integrated
disclosure provisions of the SEC as embodied in SEC Regulation S-X (1'7 C.F . R. Sections
210 .01 et seq.) and Regulation S-K (17 C .F.R. Sections 229 .10 et seq.) arid other SEC
regulations, including accurate and truthful information with respect to the Company' s
operations, financial condition and earnings so that the market price of the Company's securitie s
would be based on truthful, complete and accurate information.
146. Hanger and the Individual Defendants, individually and in concert, directly an d
indirectly, by the use, means or instrumentalities of interstate commerce and/or of the mails ,
engaged and participated in a continuous course of conduct to conceal adverse materia l
information about the business, operations and future prospects of Hanger as specified herein .
147. These defendants employed devices , schemes and artifices to defraud , while i n
possession of material adverse non-public information and engaged in acts, practices, and a
course of conduct as alleged herein in an effort to assure investors of Hanger's value an d
performance and continued substantial growth, which included the making of, or the
participation in the making of, untrue statements of material facts and omitting to state materia l
facts necessary in order to make the statements made about Hanger and its business operation s
and future prospects in the light of the circumstances under which they were made, no t
misleading, as set forth more particularly herein, and engaged in transactions, practices and a
course of business which operated as a fraud and deceit upon the purchasers of Hanger' s
securities during the Class Period.
148. The Individual Defendants' primary liability, and controlling person liability ,
arises from the following facts : (a) the Individual Defendants were high-level executives an d
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directors at the Company during the Class Period ; (b) the Individual Defendants were privy to
and participated in the creation, development and reporting of the Company's internal budgets,
plans, projections and/or reports ; and (c) the Individual Defendants were aware of the Company's
dissemination of information to the investing public which they knew or ;recklessly disregarded
was materially false and misleading .
149. The defendants had actual knowledge of the misrepresentations and omissions of
material facts set forth herein, or acted with reckless disregard for the truth in that they failed to
ascertain and to disclose such facts, even though such facts were available to them. Such
defendants' material misrepresentations and/or omissions were done knowingly or recklessly and
for the purpose and effect of concealing Hanger's operating condition and future business
prospects from the investing public and supporting the artificially inflated price of its securities .
As demonstrated by defendants' overstatements and misstatements of the Company's business,
operations and earnings throughout the Class Period, defendants, if they did not have actual
knowledge of the misrepresentations and omissions alleged, were reckless in failing to obtain
such knowledge by deliberately refraining from taking those steps necessary to discover whether
those statements were false or misleading .
150. As a result of the dissemination of the materially false and misleading information
and failure to disclose material facts, as set forth above, the market price of Hanger's securities
was artificially inflated during the Class Period . In ignorance of the fact that market prices of
Hanger's publicly-traded securities were artificially inflated, and relying directly or indirectly on
the false and misleading statements made by defendants, or upon the integrity of the market in
which the securities trade, and/or on the absence of material adverse information that was known
to or recklessly disregarded by defendants but not disclosed in public statements by defendant s
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during the Class Period, plaintiffs and the other members of the Class acquired Hanger securitie s
during the Class Period at artificially high prices and were damaged thereby .
151 . At the time of said misrepresentations and omissions, plaintiffs and othe r
members of the Class were ignorant of their falsity, and believed them to be true . Had plaintiffs
and the other members of the Class and the marketplace known of the true financial conditio n
and business prospects of Hanger, which were not disclosed by defendants, plaintiffs and othe r
members of the Class would not have purchased or otherwise acquired their Hanger securities,
or, if they had acquired such securities during the Class Period, they would not have done so a t
the artificially inflated prices which they paid .
152. By virtue of the foregoing, defendants have violated Section 10(b) of th e
Exchange Act, and Rule I Ob-5 promulgated thereunder .
153 . As a direct and proximate result of defendants' wrongful conduct , plaintiffs and
the other members of the Class suffered damages in connection with their respective purchase s
and sales of the Company 's securities during the Class Period .
SECOND CLAIM
Violation Of Section 20(a) O fThe Exchange Act Against the Individual Defenda nts
154. Plaintiffs repeat and re-allege each and every allegation contained above as if
fully set forth herein .
155. The Individual Defendants acted as a controlling person of Hanger within th e
meaning of Section 20(a) of the Exchange Act as alleged herein . By virtue of their high-leve l
positions, and their ownership and contractual rights, participation in and/or awareness of the
Company's operations and/or intimate knowledge of the statements filed by the Company with
the SEC and disseminated to the investing public, the Individual Defendants had the power to
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influence and control and did influence and control, directly or indirectly . the decision-making of
the Company, including the content and dissemination of the various statements which plaintiffs
contends are false and misleading . The Individual Defendants were provided with or had
unlimited access to copies of the Company's reports, press releases, public filings and other
statements alleged by plaintiffs to be misleading prior to and/or shortly after these statements
were issued and had the ability to prevent the issuance of the statements or cause the statements
to be corrected .
156. In particular, the Individual Defendants had direct and supervisory involvement in
the day-to-day operations of the Company and, therefore, are presumed to have had the power to
control or influence the particular transactions giving rise to the securities violations as alleged
herein, and exercised the same .
157. As set forth above, Hanger and the Individual Defendants each violated Sectio n
10(b) and Rule IOb-5 by their acts and omissions as alleged in this Complaint . By virtue of their
positions each as a controlling person, the Individual Defendants are liable pursuant to Section
20(a) of the Exchange Act. As a direct and proximate result of Hanger's and the Individual
Defendants' wrongful conduct, plaintiffs and other members of the Class suffered damages in
connection with their purchases of the Company's securities during the C lass Period .
PRAYER FOR RELIEF
WHEREFORE, plaintiffs pray for relief and judgment , as follows :
A. Determining that this action is a proper class action and certifying plaintiffs as
class representatives under Rule 23 of the Federal Rules of Civil Procedure and plaintiffs'
counsel as lead counsel for the Class ;
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B . Awarding compensatory damages in favor of plaintiffs and the other Clas s
members against all defendants, jointly and severally, for all damages sustained as a result o f
defendants' wrongdoing, in an amount to be proven at trial, including interest thereon ;
C. Awarding plaintiffs and the Class their reasonable costs and expenses incurred i n
this action, including counsel fees and expert fees ; and
D . Such other and further relief as the Court may deem just and proper.
DATED: February 15, 2005 Respectfully submitted ,
MILBERG WEISS BERSHAD &SCHULMAN LLP
c7By :Steven G. Schulman (SS-2561)Barry Weprin (BW-8637)
Peter Sloane (PS-4672)One Pennsylvania PlazaNew York, NY 10119-0165Telephone: (212) 594-5300Facsimile: (212) 868-122 9
-and-
LERACH COUGHLIN STOIA GELLERRUDMAN & ROBBINS LLP
Samuel H. Rudman (SR-7957)David A . Rosenfeld (DES-7564)Mario Alba , Jr . (MA-7240)2000 Broadhollow Road, Suite 406Melville , NY 11747Telephone : (631) 367-7100Facsimile : (631) 367-1 163
Co-Lead Counsel for Plaintiffs
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EXHIBIT A
PRESCRIPTION
PATIENT ' S NAME AND ADDRESS
GERALDINE MCKOY
47-15 206TH STREET
BAYS I DE, NY 1136 1
PHYSICIAN ' S NAME AND ADDRESS
Carl Richie
146-01 45th Avenue
Suite 205
Flushing, NY 11355
DIAGNOSIS ( ICD-9 AND/OR NARRATIVE)
8976 AMPUTATION LEG, BILAT
DESCRIPTION OF ITEM/SERVICES ORDERED
PATIENT'S DATE OF BIRTH
03/29/1925
PHYSICIAN ' S PHONE & FAX NUMBER
(718) 445-7223
PHYSICIAN'S UPIN
E22222
2 Replacement Below Knee Prosthetic Socket ; 2 Custom Shaped ProtectiveCover ; 4 Test Socket, BK ; 2 Total Contact Modification ; 2 Modular Alignable
System ; 2 Ultralight Weight Construction Material ; 2 Acrylic Socket, BK; 2
Foam Cushion Insert ; 2 Molded Distal Cushion ; 12 Below Knee ProstheticSheath ; 18 Multi-Ply Below Knee Socks ; .
FUNCTIONAL CAPACITY (from K1-K4 )
PRESCRIPTION DATE (START DATE ) EXPECTED LENGTH OF NEED
04/30/200 4
PROGNOSIS
MEDICAL NECESSITY
I AUTH IZE THE ITEMS/SERVICES SHOWN ABOVE AND CERTIFY THAT THE INFORMATION
PROVI HE IN IS TRUE AND ACCURATE .
PHYSI 'S (ORIGINAL) SIGNATURE DAT
Hanger Prosthetics & Orthotics East, Inc .
151 Hempstead Turnpike
West Hempstead,. NY 11552
(516)481-9670
Fax : (516)481-3725
PLEASE SIGN AND DATE THIS PRESCRIPTION AND RETURN IT TO US IN THE ENCLOSEDSELF ADDRESSED STAMPED ENVELOPE .
CERTIFICATE OF MEDICAL NECESSIT Y
Patient' s Name : GERALDINE MCKO Y
Date of Birth : 03/29/1925
Address : 47-15 206THSTREETBAYSIDE, NY, 11361-
Physician DetailsCarl Richie
146-01 45th Avenue
Suite 205
Flushing, NY, 11355-
Diagnosis : 8976 AMPUTATIONLEG, BILAT
Prognosis ;
Reason for Need :
Use [ ] Day [ ] Evening [ ] 24 hours
Length of Time Neede d
[ J Have Orthotist/Prosthetist call after consultation with patient
Ins. ID : 239226285B
Date: 05/17/2004
UPIN #: E22222
Telephone: (718)445-7223
Other License#:
[ I Pre-Op [ I Post-Op
RC Replacement Below Knee Prosthetic Socket ; Custom Shaped Protective Cover ;
Test Socket, BK ; Total Contact Modification ; Modular Alignable System ;
Ultralight Weight Construction Material ; Acrylic Socket, BK ; Foam Cushion
Insert ; Molded Distal Cushion ; Below Knee Prosthetic Sheath ; Multi-Ply
Below Knee Socks ;
[ ] Substitution Allowed ] Dispense as Writte n
Prescriber 's Signature 4, 0 Date ? 4 J~ y
Please return in this signed docdi ent in the enclosed, stamped self addressed envelope.
Hanger Prosthetics & OrthoticsWest Hempstead, NY
151 Hempstead TurnpikeWest Hempstead, NY, 11552
Tel : (516)481-9670
Fax : (516)481-3725
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EXHIBIT B
1Iangei1151 Hempstead Turnpike
West Hempstead, NY, 11552
VALIDATION OF RECEIPT
GEORGE KOUVARISRecipient's Nam e
HCFA Code - Quantity - Description
03/15/200 4
L5700 1 REPLACE SOCKET BELOW KNEE ; L5620 2 TEST SOCKET BELOW KNEE ; L5637 1 BELOW
KNEE TOTAL CONTACT ; L5910 1 ENDO BELOW KNEE ALIGNABLE ; L5940 1 ENDO BK
ULTRA-LIGHT MATERI ; L5629 1 BELOW KNEE ACRYLIC SOCKET ; L5645 1 BK FLEX INNER
SOCKET EXT F ; L5662 2 SOCKET INSERT BK SILICONE ; L8420 6 PROSTHETIC SOCK MULTI
PLY ; L8470 6 PROS SOCK SINGLE PLY BK;
I have received and am satisfied with the device provided to me by the above named practice . I certify that a qualified
representative of the facility named above has provided me with education concerning the care and use of my equiprme o tand/or medical supplies . Also, I understand it is my responsibility to : 1) see my prescribing physician if special mcd 4 cal
management or further care pertaining to the wearing of the orthosis/prosthesis is necessary , and 2) inform the above
facility should any adjustments be needed .
I give the above noted practice , or its representative, permission .to contact me via telephone, or by other mealis,
regarding follow-up care and/or maintenance for this device or to discuss new devices or technologies that may apply to
my medical care . . I ,
Signature of Patient or'Responsible Party
Signature of Responsible Party (acknowledging receipt only )
Address of RepresentativeStree t
Signature of Witness (if patient signing with mark )
Address of WitnessStreet
City Stat e
City State
' Da
Date
---Lip
Date
Zip
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