New COVID Bill Doesn't Address Fraud Risks


Weekly Newsletter | January 1, 2021 | Subscribe


COVID-19 Related Fraud

----------------------------------------------------------------------------------- Wall Street Journal: New Small-Business Stimulus Plan Fails to Address Fraud Risks A new COVID-19 relief plan was signed this week; however, it does not address the weaknesses of the original plan that led to COVID-19 fraud. This $900 billion $900 billion pandemic-aid bill includes an additional $284 billion for the Paycheck Protection Program to support small businesses; however, in the original relief plan, approximately 1,500 companies received about $2 billion in PPP loans have faced allegations of violating government regulations or of criminal conduct.


USA Today: How scammers siphoned $36B in fraudulent unemployment payments from US Once COVID-19 hit the US, unemployment fraud was on the rise with at least $36 billion being taken away from Americans that are out-of-work. COVID-19 unemployment fraud was first identified in May in Washington; however, it has now spread to all 50 states.


Case Settlements & Opinions

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Dept. of Justice: Texas Heart Hospital and Wholly-Owned Subsidiary THHBP Management Company LLC to Pay $48 Million to Settle False Claims Act Allegations Related to Alleged Kickbacks Texas Heart Hospital and its subsidiary, THHBP Management Company, LLC, agreed to pay $48 million to resolve claims that it violated the False Claims Act by knowingly submitting claims to Medicare that resulted from violations of Stark Law and the Anti-Kickback Statute. Heart Hospital allegedly violated the Stark Law and the Anti-Kickback Statute by requiring physician owners to satisfy its yearly 48 patient-contact requirement in order to maintain ownership in the hospital.


Dept. of Justice: Acting Manhattan U.S. Attorney Announces $40.5 Million Settlement with Durable Medical Equipment Provider Apria Healthcare for Fraudulent Billing Practices Apria Healthcare Group agreed to pay $40.5 million to resolve allegations that it submitted false claims to federal health programs such as Medicare and Medicaid to seek reimbursement for the rental of non-invasive ventilators (NIVS) to program beneficiaries who were not using the NIVS as they were not medically necessary or involved the improper waiver of patient co-insurance payments.


Dept. of Justice: Acting Manhattan U.S. Attorney Announces Settlement with Substance Abuse Treatment Center and Its Owner for Enrolling Patients Through Kickbacks and Using Falsified Patient Admissions Forms Addiction Care Intervention Chemical Dependency Treatment Centers (ACI) and its owner agreed to a $6 million settlement to resolve allegations that it provided kickbacks and engaged in fraudulent conduct in connection with the enrollment of Medicaid beneficiaries into ACI’s inpatient treatment program. ACI allegedly paid a kickback to an individual in the form of a sham job with a compensation of more than $75,0000 to induce her to refer patients to ACI programs, and it allegedly had drivers target homeless individuals and offer food and money for drugs and/or alcohol in order to enroll them in its inpatient treatment program.





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