A whistleblower advocate is urging the U.S. government to form a task force dedicated to cracking down on health care fraud targeting Medicare, Medicaid and other taxpayer-subsidized health programs during the coronavirus outbreak.
The National Whistleblower Center’s board of directors chairman Stephen Kohn sent a letter to Attorney General William Barr Monday calling for “prompt and effective action” against health care providers that attempt to defraud Medicare and Medicaid as they respond to the Covid-19 crisis.
“There is a group of people who will profit from disasters illegally and they’re despicable, but they’re out there,” Mr. Kohn told Bloomberg Law.
Protecting federal funds from fraud
The creation of a task force prepared to investigate and prosecute anyone submitting false claims to Medicare and Medicaid “can send a message to all persons involved in fighting the coronavirus that they must act honestly and ethically in their administration of these critical programs,” Mr. Kohn said in his letter to Barr.
Donald Trump’s emergency declaration last week allocates more than $50 billion in disaster relief funding that could be used for coronavirus response. Those funds come on top of more than $8 billion Congress has already earmarked for the fight against the virus.
Medicaid and Medicare provide the bulk of health insurance for most elderly Americans, who are at the highest risk of contracting coronavirus and developing life-threatening pneumonia from it. The federally funded health care programs are also the target of most false claims fraud, usually in the form of services that are wrongfully inflated, never provided, medically unnecessary, or provided through kickbacks and other improper financial arrangements.
Medicare fraud — a giant problem already
Earlier this month, the U.S. Department of Justice launched the National Nursing Home Initiative to crack down on fraud and abuse by operators that prioritize profits over patient care. Some nursing homes and other senior care facilities have been breeding grounds for Medicare fraud in recent years. Officials are concerned that the wrongdoing could get much worse if left unchecked as federal and state emergency dollars are used to combat the coronavirus outbreak.
“The Department of Justice is committed to pursuing all manner of fraud in federal health care programs, including violations disclosed by whistleblowers under the False Claims Act, especially during this critical time as our nation responds to the outbreak of COVID-19,” a Justice Department spokesperson said, according to Bloomberg Law. “We encourage anyone with information to report fraudulent acts to the appropriate authorities.”
During national emergencies, federal rules and regulations are often relaxed to expedite services. For instance, the March 6 emergency spending bill allows the Centers for Medicare and Medicaid Services to temporarily waive certain federal requirements for health care providers to bill Medicare for telehealth services.
Protecting whistleblowers from retaliation
Many legal experts believe that dishonest health care providers may take advantage of the relaxed rules and cheat federal programs. Government task forces can catch some of the Medicare and Medicaid fraud within the health care industry, but whistleblowers have first-hand knowledge of fraud that otherwise might go undetected.
Whistleblowers are also encouraged to report safety and health violations that can potentially worsen the coronavirus crisis and endanger caregivers and patients.
Federal whistleblower protections are in place to shield workers from retaliation. Most private-sector workers are covered by the Occupational Safety and Health Act of 1970 and nearly two dozen anti-retaliation statutes enforced by OSHA.
Federal employees are theoretically protected from retaliation under the Whistleblower Protection Act.
If you have any questions about whether you qualify as a whistleblower, contact one of the lawyers on our firm’s Whistleblower Litigation Team for a free and confidential evaluation of your claim. Beasley Allen lawyers Larry Golston, Lance Gould, Paul Evans, Leslie Pescia, Leon Hampton, Tyner Helms and Lauren Miles are working in this area of law known as “qui tam” cases. A lawyer on the team will be glad to discuss the potential claim with you either in person or by phone.