In one of the first of what will likely be a flood of enforcement actions, the Texas parent of an Iowa nursing home has agreed to repay $214,200 in federal monies for not following coronavirus safety protocols during an outbreak at the facility from April through July 2020. Among other things, the nursing home didn’t properly screen employees or require them to wear personal protective equipment. According to newspaper reports, three employees exhibiting COVID-19 symptoms and who subsequently tested positive for the virus were allowed to come to work and be near vulnerable residents, 11 of whom died during the outbreak. The False Claims Act Connection The relatively small settlement award belies the importance of this case. What the case illustrates is that failure to follow COVID-19 protocols can result not only in public health fines and penalties but liability under the False Claims Act (FCA). Explanation: When you bill Medicare, Medicare, Medicaid and other federal health program, you certify that you’re compliant with all applicable laws and regulatory requirements. Accordingly, labs that submitted bills during the pandemic knowing that they were out of compliance with COVID-19 safety rules run the risk of liability for submitting a false. However, the […]
In one of the first of what will likely be a flood of enforcement actions, the Texas parent of an Iowa nursing home has agreed to repay $214,200 in federal monies for not following coronavirus safety protocols during an outbreak at the facility from April through July 2020. Among other things, the nursing home didn’t properly screen employees or require them to wear personal protective equipment. According to newspaper reports, three employees exhibiting COVID-19 symptoms and who subsequently tested positive for the virus were allowed to come to work and be near vulnerable residents, 11 of whom died during the outbreak.
The False Claims Act Connection
The relatively small settlement award belies the importance of this case. What the case illustrates is that failure to follow COVID-19 protocols can result not only in public health fines and penalties but liability under the False Claims Act (FCA). Explanation: When you bill Medicare, Medicare, Medicaid and other federal health program, you certify that you’re compliant with all applicable laws and regulatory requirements. Accordingly, labs that submitted bills during the pandemic knowing that they were out of compliance with COVID-19 safety rules run the risk of liability for submitting a false.
However, the settlement in this case was actually based not on FCA liability but on “restitution,” which is typically used to describe repayment of money received by mistake. It’s also worth noting that the company in this case cooperated in the investigation, which is a highly advisable strategy if your lab comes under investigative scrutiny. In the meantime, continue to follow the COVID-19 screening, PPE and other safety rules scrupulously.
