SHARE

April 29, 2022

DOJ Targets COVID Related Fraud

You've Reached Your
Free Article Limit This Month
Subscribe now to get unlimited access to all Law.com OnPractice content. Your subscription is free.
Subscribe Now

On March 10, 2022, the Department of Justice ("DOJ") appointed a Director for COVID-19 Fraud Enforcement.[1] As a part of this announcement, DOJ announced some of its priorities in Health Care Fraud enforcement. The priorities focus on kickbacks, utilizing the relaxed rules to bill for medically unnecessary or never performed services, vaccine-related fraud, and fraud related to accessing COVID relief funds.

As a part of this enforcement priority, on April 20, 2022, DOJ announced 21 indictments related to approximately $150 million dollars in alleged COVID-19 fraud.[2] The nature of these cases run the gamut of health care fraud allegations. Here are some of the prominent cases being pursued:

Anti-Kickback Violations

The largest case, involving approximately $144 million in alleged fraudulent billing, was related to a laboratory allegedly paying kickbacks to marketers who obtained specimens and orders from providers that were then billed to federal health care programs. In addition, one of the laboratory owners had been excluded for decades and thus could not be an owner of an entity that billed federal health care programs.

In another case, a defendant is accused of paying kickbacks to marketers to solicit orders for durable medical equipment that patients did not want or need.

Medically Unnecessary Testing

Several cases involved providers taking advantage of the relaxed COVID-19 rules. These rules were designed to increase medical access to patients during the public health emergency. Still, some providers would abuse these rules by ordering and billing for medically unnecessary testing, services, and supplies that were never performed. In some instances, defendants utilized the relaxed telehealth rules to pay kickbacks in the form of "sham" telehealth consulting fees to induce referrals for services and equipment.

In one case, a physician obtained patient information by performing COVID testing on the patient. The physician allegedly used that information to bill for office visits that were not performed.

Vaccine Related Fraud

An interesting, yet concerning, area of fraud that has developed is related to COVID vaccinations. Some defendants have been distributing fraudulent vaccinations and/or fraudulent vaccination cards.

Several defendants are accused of providing "homeoprophylaxis immunizations" and then filling out COVID vaccination cards as if the patient received an approved vaccination or treatment. Such homeoprophylaxis immunizations are not FDA-approved, and it was inappropriate to list these immunizations on the vaccination cards.

In other cases, defendants were alleged to have forged vaccination cards for individuals. In one case, the defendant had access to actual vaccination lot numbers and allegedly filled out vaccination cards for patients with this information without providing the essential vaccinations. In other cases, the forged cards were simply false records. Some reportedly did this with an intent to undermine CDC efforts, while others were allegedly motivated by profit.

COVID Relief Fraud

The final area of alleged fraud related to providers who file fraudulent applications for Provider Relief Funds and/or falsely testified as to the use of the funds. Most of the allegations indicate that rather than returning the funds the providers were not entitled to, the funds were instead diverted to providers for personal use.

As the public health emergency (hopefully) ends, DOJ will likely continue to ramp up its efforts to investigate cases against providers and others that took advantage of the COVID emergency to make a profit or for other inappropriate purposes. Expect to see headlines like this for some time to come.

ALM expressly disclaims any express or implied warranty regarding the OnPractice Content, including any implied warranty that the OnPractice Content is accurate, has been corrected or is otherwise free from errors.

More From Dickinson Wright PLLC

401(k) Plan Sponsors - It Doesn't Pay To Ignore Your Plan's Definition Of Compensation

By Jordan Schreier Dickinson Wright PLLC June 06 , 2022

One of the most common errors in 401(k) plan administration continues to be a mismatch between a plan’s definition of compensation and the actual compensation taken into account for plan purposes despite this problem being common enough for the IRS to include it in its “401(k) Plan Fix-It Guide”.

All My Exes Live In Texas: Texas' New Laws In The Wake Of #METOO And A Growing Economy

By Adrian Acosta Dickinson Wright PLLC May 23 , 2022

With Texas growing and business booming, the Lone Star State has changed its laws that affect employers in response to the #MeToo movement.

UPDATE: FEC Candidate Loan Repayment Limitation Ruled Unconstitutional in Supreme Court Decision

By Katherine N. Reynolds Dickinson Wright PLLC May 18 , 2022

On May 16, 2022, the United States Supreme Court ruled that limiting the repayment of candidate loans to their own campaign to $250,000 (codified under 52 U.S.C. § 30116(j)) is unconstitutional. The Plaintiffs, Ted Cruz for Senate and Senator Ted Cruz, filed suit against the Federal Election Commission (“FEC”), stating that the repayment limitation unconstitutionally infringes the First Amendment rights of the Senator, the Campaign, and any individuals who might seek to make post-election contributions.

More From Health Care

Proposals to Reform the UK Data Protection Regime

By Sharon Lamb McDermott Will & Emery June 15 , 2022

On 10 May 2022 and as part of the Queen’s speech, which sets out the programme of legislation for the forthcoming parliamentary session, the government announced proposals to table a Data Reform Bill (the Bill) to reform the UK’s data protection regime and to diverge from European GDPR1. This follows the consultation by the Department for Digital, Culture, Media and Sport (DCMS) consultation released last September.

Preparing for the Demise of Roe v. Wade and the Criminalization of Abortion in Some US States: Practical Considerations for a Post-Roe World

By David Quinn Gacioch McDermott Will & Emery June 14 , 2022

Sometime in the next several weeks, the Supreme Court of the United States will issue its decision in Dobbs v. Jackson Women’s Health Organization (Dobbs). Based on the draft majority opinion authored by Justice Samuel Alito that was leaked to Politico in early May, there is a significant chance that the Court will overrule Roe v. Wade (Roe) and Planned Parenthood v. Casey (Casey) by holding that there is no federal constitutional right to obtain an abortion and leaving individual states free to substantially restrict abortion or prohibit abortion altogether.

US Ends COVID-19 Testing Requirement for Inbound Air Travelers

By Laura Foote Reiff Greenberg Traurig June 14 , 2022

As of June 12, 2022, the Centers for Disease Control and Prevention (CDC) no longer requires air passengers traveling to the United States from a foreign country to show a negative COVID-19 test. The requirement, implemented in early 2021, mandated that all inbound travelers present a negative COVID-19 test result prior to boarding a U.S.-bound flight. The new policy allows travelers, citizens, and non-citizens alike to board U.S.-bound flights without testing for COVID-19.

Featured Stories
Closeclose
Search
Menu

Working...