One finds fraud in cases where there is paid medical care involved. It has increased further in the new age of testing, treatment, and vaccination. Today, COVID fraud is the reality of the years 2020 and 2021, and fraudsters have become smarter.
John LeBlanc of Manatt highlights the current scenario today
John M. LeBlanc is a widely respected healthcare lawyer with the USA’s credible law firm Manatt LLP. He has over 28 years of experience in litigation and regulatory control matters that influenced the country’s healthcare and managed care industries. He represents several of the country’s prominent healthcare plans and insurers, including California’s largest not-for-profit healthcare service plan. He also represents major trade associations in America.
With the increase in infection, cases of fraud are surging too
He says the cases of fraud have rampantly increased, just like the disease and its prevention. These scams and misdeeds are not a good thing at all. He points out to a U.S Acting Assistant Attorney General who has said in the month of March, “To anyone thinking of using the global pandemic as an opportunity to scam and steal from hardworking Americans, my advice is simple—don’t.”
As the human race continues to vaccinate people, both the state and the federal law enforcement agencies are really working hard to investigate and prosecute the offenders guilty of COVID-19 related healthcare frauds.
An insight into the misappropriation of funds from the Provider Relief Fund
John LeBlanc of Manatt says that one of the largest sources of medical; fraud is also one of the healthcare system’s largest sources of relief- the CARES ACT, also known as the Provider Relief Fund. The government is currently targeting those people who are receiving funds from the Provider Relief Fund. He adds that these funds are distributed via grants or other payment mechanisms to healthcare providers who are eligible to reimburse them for costs related to medical care or any sort of lost revenue attributed to COVID-19.
However, all these healthcare providers retaining the payments from the Provider Relief Fund should certify that they should be used only for these purposes and should attest to all the terms and conditions linked to the payments as well as other relevant regulations and statutes.
Last February, the Department of Justice indicted the first individual in the country accused of misappropriating funds from the Provider Relief Fund. It charged a woman from Michigan with the embezzlement of government property. This indictment alleges that the woman in the past owned a healthcare facility that shut down in the early part of 2020 after Medicare had demanded the return of over $ 1 million in overpayments.
John LeBlanc of Manatt says, “The facility submitted claims for patients who did not qualify for home health services.According to the indictment, the provider was never operational during the pandemic, yet it received over $37,500 from the Provider Relief Fund—funds that were then given to family members for personal use.”