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Increased Federal Funds, Incentives, and Requirements for Nursing Homes Brings Worrisome Opportunities for Fraud

Posted  06/5/20
wheelchair in the hospital lobby
The pandemic has exposed the razor thin margin for error by which our most vulnerable are cared for in nursing homes. New aggregate federal data reveal the appalling toll on facility residents and staff: over 31,700 deaths as of June 4, 2020 (an undercounted 1/3 of all US COVID-19 deaths), according to the federal government’s Nursing Home Compare.  Responsive federal funding for nursing homes, requirements for...

Protests Turn a Glaring Spotlight on the Big Business of Outfitting the Police

Posted  06/4/20
local police badges scattered around
The groundswell of protest against police brutality after George Floyd’s murder has rightly turned the world’s attention to the harsh tactics employed by police departments and the racist biases in how those tactics are applied.  Shocking images have emerged from around the U.S. of police officers ready to respond to protesters, outfitted like military, looking like they are going into battle.  How did we get...

Fraudsters Beware: Flurry of Recent Actions in Enforcement Show that Contracting Fraud is a Priority

Posted  06/3/20
Business sign saying "Come In We're Open" in white on blue background
Four recent state and federal actions indicate that government contracting fraud cases are in the spotlight. These actions all stemmed from alleged violations of laws that give certain businesses, such as, small, minority-owned, or veteran-owned businesses, advantages in obtaining government contracts. These contracts are often called “preference” or “set-aside” contracts and the goal of these laws is to...

Financial Pressures on U.S. Hospitals, Combined with New Funding, Increase Risk of Medicare and Medicaid Fraud

Posted  05/22/20
Multistory hospital building set amid trees
Hospitals are an institution we might have expected to be prepared for a healthcare crisis.  It is their job, after all, to provide emergency and intensive healthcare.  In fact, however, the COVID-19 crisis has put enormous pressures on hospitals.  With such new pressures come new risks of healthcare fraud at hospitals.

The Financial Pressures on Hospitals in the COVID-19 Crisis

Against the backdrop of heroic...

COVID Frauds of the Week: Unproven Tests, Nonexistent Equipment, Price Gouging, and $10 Million in SBA Loans

Posted  05/15/20
sample test tubes scattered around
Fraudsters continue to attempt to capitalize on anxiety and uncertainty during the pandemic by marketing unproven products and services for the prevention, treatment, or cure of COVID-19. This week, we highlight the massive FTC efforts to identify and shut down illegal activities via Warning Letters (around 100 issued to date); two new SEC actions; as well other government actions to quash sales of unproven or...

Private Equity Ownership of Nursing Homes Might Have Made Everything Worse

Posted  05/15/20
person pocketing money in a business suit
Most nursing homes already had no room for error before COVID-19.  Years of private equity ownership and competition with other elder-care services dealt a one-two punch to the cash-strapped facilities’ ability to react to the pandemic crisis, says The New York Times in a troubling analysis.  In particular, private equity firms’ relentless quest for profits, miniscule margins, and regular cash-draining...

Let’s Talk about Nursing Homes – Who Will Raise the Red Flag Now That Routine Inspections Are Halted?

Posted  05/14/20
nurse checking on elder woman
In March 2020, the federal government abruptly paused non-emergency inspections of some 15,300 nursing homes and other long-term healthcare facilities nationwide in order to focus on preparations to respond to the threat of COVID-19 pandemic.  This triage means that an on-site survey will be authorized only in cases of “immediate jeopardy” of serious harm (e.g., abuse) or reported infection-control...

COVID Frauds of the Week: First Charges for Fraud on the PPP

Posted  05/8/20
Handcuffed business-leader walking through jail.
As the COVID-19 crisis continues, so too do the reports of brazen fraud against the vulnerable and the government programs designed to help them.  Like last week, here in our new feature we will focus on some noteworthy trends in government enforcement in this unfortunate new area of fraud.

Fraud on Government Spending

Notably, we have seen the first of what will undoubtedly be many government enforcement actions...

De Vos’s Education Department Quietly Granted For-Profit Mogul's Colleges Non-Profit Status, Reversing Obama Administration’s Decision

Posted  05/4/20
grad cap on hundred dollar bills
In the wake of scandals surrounding the for-profit college model, some institutions—and their executives—have sought to transition to non-profits.  These conversions pose the concrete risk that taxpayers will be left subsidizing institutions trying to skirt federal regulations meant to protect students.  As a result, the Obama Administration scrutinized them carefully, particularly where the rebranded non-profit...

Antitrust Violations, COVID-19, and the False Claims Act

Posted  04/23/20
whistle hanging on rope
As the federal government spends trillions of dollars to fight the coronavirus pandemic and alleviate its economic fallout, we can expect to see large chunks of that money misused and misappropriated by bad actors.  Now more than ever, we’ll need whistleblowers to come forward to report what they see on the ground, whether it’s an unqualified company seeking Paycheck Protection Program funds intended for small...
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