ReNew Health Group LLC, along with its subsidiary ReNew Health Consulting Services LLC, and two corporate executives, have agreed to a civil settlement of $7,084,000 with the United States and the State of California.
The settlement resolves allegations of submitting false Medicare Part A claims for nursing home residents.
The settlement stems from accusations that the defendants knowingly exploited a waiver during the COVID-19 pandemic. The waiver relaxed the requirement for a minimum three-day hospital stay before reimbursing for skilled care in a nursing home, aiming to conserve hospital beds.
However, authorities alleged that ReNew Health Group and its executives abused this waiver. They purportedly routinely submitted claims for nursing home residents who did not have COVID-19 or any other acute illness but were simply in proximity to individuals with the virus.
Under the terms of the settlement, ReNew Health Group, its subsidiary, and the executives will pay $6,841,727 to the United States and $242,273 to the State of California, along with interest.
Principal Deputy Assistant Attorney General Brian M. Boynton emphasized the Justice Department’s commitment to safeguarding taxpayer-funded programs, stating:
“We will hold accountable those who sought to defraud such programs during the COVID-19 pandemic, including those who knowingly misused emergency waivers for personal gain.”
U.S. Attorney Martin Estrada for the Central District of California echoed this sentiment, highlighting the importance of combating false claims in the Medicare system, particularly during public health crises.
The investigation into these allegations was initiated by a lawsuit filed under the whistleblower provisions of the False Claims Act.
The whistleblower, Bay Area Whistleblower Partners, will receive $1,204,280, plus interest, as their share of the settlement.
The case, titled United States and State of California ex rel. Bay Area Whistleblower Partners v. ReNew Health Group LLC et al., was handled by Senior Trial Counsel Albert P. Mayer of the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and Assistant U.S. Attorney Karen Y. Paik for the Central District of California.