Zimmerman Reed announces
$7 million settlement for the U.S.
and State of California in a
first-of-its kind False Claims Act case involving a COVID-19 waiver
program.
MINNEAPOLIS, Minn., April 29,
2024 /PRNewswire-PRWeb/ -- Zimmerman Reed announced today that the United States and the State of California reached a $7 million settlement with ReNew Health
Group LLC, ReNew Health Consulting Services LLC, and its owner-CEO
and its COO to resolve False Claims Act allegations filed by
Zimmerman Reed's whistleblower
clients. ReNew Health, the owner and operator of dozens of nursing
facilities throughout California,
allegedly submitted millions of dollars of fraudulent
claims to Medicare and California Medicaid since March 2020 under a scheme involving a COVID-19
waiver program.
"This case emphasizes the vital contribution that whistleblowers
can make in exposing healthcare fraud," said
June Hoidal, chair of Zimmerman Reed's Whistleblower practice. "The
courage of our clients who reported improper Medicare and Medicaid
claims was instrumental in bringing this case to light and securing
a just result."
"Along with the whistleblowers who uncovered these wrongdoings,
we commend the United States and
the State of California for
thoroughly investigating these allegations and bringing this case
to resolution," said Chuck
Toomajian, counsel for the whistleblowers and a member of
Zimmerman Reed's Whistleblower
practice. "Their diligence resulted in recovering substantial
overpayments and is critical in protecting taxpayers and government
health care programs against these schemes."
To free up hospital beds during the COVID-19 crisis, the Centers
for Medicare and Medicaid Services (CMS) temporarily waived its
rule requiring a minimum three-day hospital stay before Medicare
Part A would cover skilled care in a nursing home that qualifies as
a skilled nursing facility (SNF). Due to this waiver, a person who
had Medicare Part A and needed skilled care could move directly
into a nursing home qualifying as an SNF to receive that care.
Likewise, a person already living in a nursing home that qualified
as an SNF could remain there to receive that care. Under either
scenario, the nursing home could then submit claims for payment for
providing that skilled care under Medicare Part A. CMS also waived
the 100-day limit on Medicare Part A coverage of skilled care under
certain circumstances. These waivers expired in May 2023.
The whistleblowers alleged that, after learning of
these waivers, ReNew Health began submitting false Medicare and
Medicaid claims for skilled care for residents in their nursing
homes, basing the claimed need for skilled care on the possibility
that the residents were exposed to COVID-19. Typically, skilled
care involves the treatment of severe illness or injuries such as
heart attacks, pneumonia, or significant orthopedic issues.
Zimmerman Reed was pleased to
work on this matter with co-counsel Gary
Azorsky and Ray Sarola of
Cohen Milstein Sellers & Toll,
and David Brevda of Senior Justice
Law.
The federal False Claims Act and its state law equivalents
empower private citizens to sue on the government's behalf against
persons who present false claims for payment under government
contracts or programs. Successful whistleblowers, like those who
brought this lawsuit, are entitled to a share of any recovery
obtained through settlement or judgment against a defendant.
Media Contact
Albert Leung, Zimmerman Reed, 1 612-341-0400,
albert.leung@zimmreed.com, www.zimmreed.com
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content:https://www.prweb.com/releases/renew-health-to-pay-7-million-to-settle-first-of-its-kind-covid-19-false-claims-act-case-302130624.html
SOURCE Zimmerman Reed