A Monrovia-based nursing home chain and its executives have agreed to pay more than $7 million to settle COVID-19-related false claims allegations, it was announced Friday.
ReNew Health Group LLC, ReNew Health Consulting Services LLC, and two corporate executives agreed to the settlement with federal and state prosecutors for knowingly submitting false Medicare Part A claims for nursing home residents, according to the U.S. Department of Justice.
To conserve hospital beds during the COVID-19 pandemic, the Centers for Medicare and Medicaid Services waived the requirement that a person must have had a hospital stay of at least three days -- signaling an acute illness or injury -- before reimbursing for skilled care in a nursing home.
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The federal government and the state of California alleged that the defendants knowingly misused this waiver by routinely submitting claims for nursing home residents when they did not have COVID-19 or any other acute illness or injury, but merely had been near other people who had COVID-19, the DOJ said.
Under the settlement, the defendants will pay $6,841,727 to the United States and $242,273 to the state of California, plus interest, it was announced.
"False claims are anathema to the Medicare system, especially during a public health crisis," U.S. Attorney Martin Estrada of the Central District of California said in a statement. "This settlement agreement highlights my office's determination to ensure our nation's health care programs help those who actually need them."
The investigation was prompted by a lawsuit filed under the whistleblower provisions of the False Claims Act, which permit private parties to sue on behalf of the government to redress false claims for government funds and to receive a share of any recovery. The DOJ said the settlement agreement provides for the whistleblower, Bay Area Whistleblower Partners, to receive $1.2 million, plus interest, as its share of the settlement.
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