“Under regulations instituted as a result of the COVID-19 public health emergency, skilled nursing facilities are reporting a wealth of information to the federal government — on top of all the information they were required to submit pre-pandemic.
And that information could end up being the guiding light for the U.S. Department of Justice (DOJ) and the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), according to a webinar hosted Thursday by the continuing education provider Strafford.
The presentation focused on reporting requirements for SNFs, government enforcement actions and compliance, and preparation for enhanced enforcement.”
“Is this really the perfect storm, then, for a potential wave of lawsuits initiated by DOJ with a much richer database for targeting facilities with with a record in infection control surveys and IJs [immediate jeopardy deficiencies]?” McGovern asked on the webinar. “Time will tell about that. But it’s not simply DOJ. If DOJ doesn’t take the initiative, whistleblowers can also bring lawsuits under the False Claims Act (FCA) and seek to recover the considerable damages afforded under the FCA.”
FCA cases relate to the conduct of private companies that do business with Medicare, Medicaid, and other public health care funding sources, and generally involve fraud, as Bloomberg noted in September 2019 covering an announcement by the DOJ that it would pursue criminal charges in such cases that involved nursing homes.
Many of the claims that hit nursing homes related to the provision of therapy, such as the $30 million settlement agreed to by the Louisville, Ky.-based Signature HealthCARE, the $15 million settlement from Brockway, Pa.-based Guardian Elder Care, or the saga related to the case of several SNFs and a therapy company that eventually settled for $255 million.
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