ReNew Health, a California-based nursing home chain, has settled a Medicare fraud lawsuit for $7 million tied to pandemic-era waivers, according to recently unsealed court filings.
The lawsuit claims that ReNew falsely billed Medicare for skilled nursing stays using the 3-day hospital waivers issued by the Centers for Medicare & Medicaid Services (CMS).
The Department of Justice and the state of California alleged that ReNew made it a practice to submit claims for SNF services for residents with COVID – and even those who were simply exposed to the deadly virus.
“ReNew leadership personnel incorrectly reasoned that many long-term residents of their nursing homes needed skilled care, based on the possibility that the residents could get COVID-19,” the lawsuit states. “And thus ReNew [and affiliates] hereto could submit Medicare Part A claims for them, and get paid substantially more money than they would get paid on standard nursing home claims.”
ReNew Health will pay $6,841,727 to the federal government and $242,273 to the state of California, plus interest as part of the settlement agreement.
A spokesperson for ReNew told LAist that the settlement resolved claims “with no finding of wrongdoing.”
“ReNew has consistently prioritized the highest regulatory and ethical standards in all our business processes,” said Dan Kramer. “The settlement, like those many other health systems and hospitals have reached with the government, is completely unrelated to patient care or the quality and appropriateness of the care or services provided to patients, instead involving an administrative issue during the COVID era when overlapping and often conflicting rules and regulations sometimes changed weekly or daily,”
Kramer said the settlement will not affect ReNew’s patients, caregivers or services.
The federal and state investigation into ReNew Health Group, which is connected to over two dozen facilities across California, started after whistleblowers filed a lawsuit under the False Claims Act in October 2020. The case was sealed until a settlement was reached last month.
“The government has done an exceptional job in using its enforcement powers to recover money and programs that were instituted during the COVID pandemic,” Ray Sarola, an attorney at Cohen Milstein Sellers & Toll, which represented the whistleblowers in the ReNew lawsuit, is quoted as saying in the LAist article.