The United States of America and ReNew Health Group LLC have settled a nursing home whistleblower claim involving allegations that the nursing home chain submitted false Medicare claims.
In a landmark settlement, Renew Health has agreed to pay over $7 million to resolve claims under the False Claims Act (FCA) for knowingly submitting false Medicare Part A claims for nursing home residents.
This fraudulent conduct was uncovered by Senior Justice Law Firm partners David Brevda and Michael Brevda, while investigating a nursing home injury case. Senior Justice Law Firm then represented the whistleblower relators in the subsequent qui tam action, successfully recovering a $7,084,000 civil settlement.
Covid Medicare Fraud Explained
Medicare is the primary payor for most of the nation’s nursing home beds. Normally, Medicare requires a 3+ day hospital stay before a nursing home can get reimbursed for skilled nursing care.
However, during the Covid pandemic, Medicare lifted this 3+ hospital day requirement and allowed nursing homes to get reimbursement immediately on Covid patients. Some nursing home operators knowingly misused the emergency Covid waiver and submitted false claims for nursing home residents.
In the Renew case, the whistleblowers alleged that, after learning of the emergency change to Medicare’s Covid policy, ReNew Health falsely told Medicare that many residents in their nursing homes needed skilled care based on the possibility that they were exposed to Covid. This was in violation of the terms of the COVID-19 waiver program.
How Senior Justice Law Firm Uncovers Nursing Home Fraud
The specialized nursing home abuse attorneys at Senior Justice Law Firm handle injury and wrongful death claims against healthcare facilities. Even though our cases involve individual injuries like bed sores or broken bones, our investigation always focuses on a potential larger cause for the harm.
Nursing home understaffing and Medicare fraud poison a facility from the top down, creating an environment of neglect and carelessness. This tragically translates to needless resident injury.
In our nursing home injury cases, our attorneys actively search for corporate misconduct. This can mean comparing staffing data, budgets, related party transactions, and Medicare/Medicaid reimbursements in an effort to unearth a larger corporate conspiracy. Speaking with former employees about suspicious corporate behavior also can lead to uncovering corporate nursing home Medicare fraud.
In this case, attorney David Brevda was instrumental in piecing together the nursing home chain’s conspiracy to defraud Medicare.
Utilizing the firm’s contacts at the US Department of Justice, Senior Justice Law Firm is uniquely positioned to expose company-wide fraud and work hand-in-hand with the US government in prosecuting qui tam cases.
Takeaways from the Renew Qui Tam Case
The Renew Medicare Covid waiver case underscores the importance of rigorous oversight to safeguard public resources and uphold the integrity of our long term care system. Senior Justice is proud to have worked alongside attorneys Ray Sarola, Albert Mayer, Karen Paik, Susan Gillin, Zimmerman Reed LLP, and the Department of Health and Human Services’ Office of Inspector General to expose this fraud.
Transparency, accountability, and a steadfast dedication to ethical conduct must remain paramount in all facets of healthcare. Elderly patients are not widgets that a private ownership group can profit from. They are human beings. These are our parents, spouses and siblings. Our vulnerable loved ones deserve protection.
David Brevda, Partner, Senior Justice Law Firm
By fostering a culture of integrity and vigilance, we can ensure that the trust given to nursing homes is not misplaced. The pursuit of justice must prevail over deception and fraud.
In the end, the true measure of our commitment to the principles of honesty and fairness lies not in the settlements reached or the penalties imposed, but in the actions we take to prevent similar injustices from occurring in the future.
Nursing home abuse and neglect is rooted in corporate fraud. We can only protect residents from injury if we clean up the long term care system and expose this fraud.
Every nursing home injury case offers an opportunity to analyze how the corporate parent company operates its business. We are always looking to uncover fraud and work with our partners at the DOJ. As we get deeper into litigation in a nursing home injury case, we hire forensic accounting experts, private investigators, and speak with former employees. We believe that an individual injury case can make a difference, but company-wide qui tam actions can generate transformative waves of positive change.
Michael Brevda, Managing Partner, Senior Justice Law Firm
Free Nursing Home Qui Tam Case Consultation
Senior Justice Law Firm is actively investigating numerous false claims Medicare qui tam cases against nursing home operators. If you have potential information involving Medicare fraud inside a nursing home, contact our nursing home qui tam attorneys today to learn more about how whistleblowers are compensated for exposing fraud.
Receive a free, confidential case consultation now by calling Senior Justice Law Firm at 888.375.9998.
Read the actual Renew settlement agreement here, as posted by the US Department of Justice.
The claims settled by the United States are only allegations. There was no determination of liability.
