Nursing Home Fraud Whistleblower Attorney Speaks At American Bar Association’s 2023 Public Procurement Symposium

Philadelphia, PA. On November 3, 2023, Nursing home fraud Whistleblower attorney, Kandis Kovalsky spoke on an in-person panel about “When Grants Go Bad and False Claims Arise” at the American Bar Association (ABA) Public Contract Law Section’s 2023 Public Procurement Symposium at the Loews Hotel in New Orleans, Louisiana.

Other panelists included Habib Ilahi of the law firm Schertler Onorato Mead & Sears, LLP as moderator; Geeta Taylor, Senior Counsel in the Office of Counsel to the Inspector General, U.S. Department of Health and Human Services (HHS-OIG), and Taylor Brown, Counsel and Practice Lead at IBM.

The panel discussed recent enforcement trends in federal grants, focus areas for grant fraud allegations, and best practices for federal grantees to reduce risk.

The ABA Section of Public Contract Law’s Annual Public Procurement Symposiums present a unique opportunity for practitioners to learn about emerging issues in the ever-evolving world of federal, state, and local procurement.

Nursing home fraud encompasses a range of illegal or unethical activities conducted by nursing homes or their staff members, aiming to gain financial advantage at the expense of residents or government healthcare programs. This type of fraud manifests in various forms, including billing fraud, kickbacks, false documentation, quality of care issues, Medicare/Medicaid fraud, staffing fraud, and medication fraud. These deceptive practices not only jeopardize the well-being of residents by providing inadequate care or unnecessary treatments but also defraud taxpayers and strain government healthcare programs. Nursing home fraud can lead to severe legal repercussions such as fines, penalties, and criminal charges for those involved.

Billing schemes involve submitting false claims for reimbursement, including overcharging for services not rendered or billing for unnecessary treatments. Kickbacks occur when nursing homes receive financial incentives in exchange for referring residents to specific suppliers or service providers. Quality of care fraud entails misrepresenting the level of care provided to residents to receive higher reimbursements, while staffing fraud involves misrepresenting staff qualifications or billing for services performed by unqualified personnel. Medication fraud involves overprescribing medications or administering unnecessary treatments to increase billing for pharmaceuticals or therapy services. False documentation includes falsifying medical records to support fraudulent claims or cover up instances of substandard care.

Nursing home fraud whistleblower lawyers play a critical role in addressing instances of fraud, assisting various parties affected by or involved in fraudulent activities. These parties may include residents and their families seeking compensation for harm caused by fraud, whistleblowers reporting fraudulent activities, healthcare professionals navigating legal obligations, government agencies investigating allegations, and nursing home owners or administrators defending against accusations.

Legal proceedings related to nursing home fraud can occur in different jurisdictions, including state, federal, civil courts, administrative proceedings, or alternative dispute resolution methods like mediation. Nursing home fraud lawyers help clients navigate these legal processes and advocate for their rights and interests.

People care deeply about nursing home fraud due to its impact on vulnerable populations, breach of trust, financial exploitation, ethical concerns, and broader implications for the healthcare system. Reports indicate the prevalence of nursing home fraud, highlighting the need for enhanced regulatory oversight, enforcement actions, whistleblower protections, and prevention/detection efforts to combat this issue effectively. Understanding these additional facts about nursing home fraud is crucial for stakeholders to work towards solutions to protect vulnerable residents and uphold integrity in healthcare.