COVID-19 Will Lead to New False Claims Cases

The COVID-19 virus is inspiring new private-public relationships that will lead to a new generation of whistleblower cases under the Federal False Claims Act.

Government is injecting billions of dollars into the private sector for medical devices and necessary healthcare equipment. The private sector is now supplying everything from tests to masks and ventilators. In the massive purchase of products and services there is not a corresponding gearing-up in oversight. Whistleblowers will be essential in documenting defective products, and false billing for services or products not supplied or rendered.

The fraud will not just be limited to medical products; state and federal governments are spending billions to build temporary medical facilities and there is no doubt that there will be fraud, waste and abuse in their construction.

To keep the economy from collapsing, the government has made grants and loans worth billions of dollars. Recipients of government funds must make truthful representations on their loan or grant applications and they must continue to meet the requirements of the loan or grant for an extended period of time. The conditions of receipt of government funds are as detailed as the requirement that a recipient remain neutral in a union organizing campaign; in other words, ripe for misuse.

The bottom line; COVID-19 has created a new role for Whistleblowers.

Telemedicine Fraud

Telemedicine is the use of real time face to face telecommunication by a doctor or clinician to treat a patient at a distant site.  The live patient communication software platform is designed and provided by companies that specialize in providing services to the medical field.

For telemedicine to occur three factors must be present:

  • Different locations of provider and patient at time of treatment
  • Treatments and services completed must be clinical in nature 
  • Asynchronous (live two way) communication

Currently, for telemedicine to be lawful the physician must be at a “hub-site” (designated medical care location) and the patient at an “spoke-site” (distant origination location).  

When medical coverage is available to patients at a distant location, doctors or licensed medical practitioners can treat them clinically.  At-a-distance clinical medicine is also part of the telemedicine definition and is what differentiates it from telehealth.