Several new laws provide funding for companies and health care providers to cover expenses and lost revenue associated with COVID-19 treatment. For example, the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”), as supplemented by the Paycheck Protection Program and Health Care Enhancement Act (the “PPP/HCE Act”), provided $175 billion in relief funds to hospitals and other providers on the front lines of the COVID-19 response.

But the new funding has been accompanied by a government crackdown on fraud. Various officials have stated that they are prioritizing the investigation of criminal and civil fraud related to pandemic funding. They have urged the public to report suspected fraud schemes related to COVID-19, including providers fraudulently billing for tests and procedures.

This Briefing will focus on anti-fraud statutes that are likely to be implicated by the government’s increased enforcement efforts. The primary law affecting this crackdown is the False Claims Act, 31 U.S.C. §§ 3729 et seq. (“FCA”). The FCA imposes liability for knowingly presenting a false or fraudulent claim or making a false record or statement material to a false or fraudulent claim. The Department of Justice has affirmed that it remains “committed to pursuing” violations of the FCA, “especially during this critical time as our nation responds to the outbreak of COVID-19.”

Please join Haynes and Boone, LLP partners Stacy L. Brainin and Bill Morrison as well as Spencer Fane, LLP partner Sean McKenna as they:

    Provide an overview of the FCA and the funds available to health care providers dealing with COVID-19 [15 minutes]
    Explain the types of FCA cases that may be brought by the government in the wake of the COVID-19 pandemic [10 minutes]
    Discuss the “false certification” theory of FCA liability, which may be particularly relevant for entities receiving federal funds under the CARES Act and PPP/HCE Act [10 minutes]
    Discuss the types of entities and health care plans that may be subject to additional government scrutiny, including nursing homes and Medicare Advantage plans [15 minutes]
    Outline best practices for entities receiving federal funds to avoid FCA liability [10 minutes]