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WASHINGTON (Reuters) – Eager to strengthen the health system during the coronavirus pandemic, the United States government spent $ 30 billion last month on stimulus payments to most health care providers who billed Medicare on last year.
That speed resulted in the flow of taxpayers’ money to some companies and individuals facing criminal or civil fraud investigations, according to defense attorneys and others representing more than a dozen companies and individuals facing such investigations.
The revelations about such payments have sparked outrage from some Democrats in Congress, who say they highlight problems with the distribution of stimulus funds.
“I have a tremendous amount of frustration with the way the Trump administration is distributing these dollars, and examples like these magnify the consequences of White House efforts to limit transparency and oversight,” said Senator Ron Wyden, member high ranking member of the Senate Finance Committee. he told Reuters.
Henry Connelly, Speaker of the Speaker of the House of Representatives, Nancy Pelosi, added: “It is alarming to see the Trump administration giving precious taxpayer dollars to unscrupulous entities while so many hospitals and healthcare workers are on the front line of the battle against the coronavirus are desperate for resources. “
The Department of Health and Human Services, which sent the payments, told Reuters that it relayed funds to all medical providers who submitted bills in 2019 to Medicare, the federal health insurance program for older and disabled Americans, unless they have already been excluded from participating.
He declined to respond to criticism from Wyden and Pelosi’s office and did not respond to specific questions from Reuters about the payments.
Katherine Harris, a spokeswoman for the HHS Office of Inspector General, said her office oversees the program, but declined to comment on the specific distribution of funds.
“While we cannot specifically comment on any work other than what has been publicly announced, I can tell you that we regularly conduct reviews of the department’s program management, including the distribution of funds,” Harris said.
Reuters was unable to independently determine how much of the stimulus payments went to entities and individuals involved in civil and criminal actions with Medicare.
In an email to funding recipients seen by Reuters, HHS asked providers to sign an extensive certificate stating that they have been or will be treating patients with COVID-19, the disease caused by the new coronavirus.
If providers do not respond within 30 days, HHS said it will assume they have accepted the government’s terms and conditions. He said in a statement that “it has mechanisms to recover funds and tackle fraudulent activities.”
Funding comes from the $ 2.3 billion CARES Act passed by Congress to mitigate the economic cost of the pandemic, which killed more than 64,000 Americans and left at least 30 million people unemployed.
Unlike portions of that package intended to help small businesses, which required companies to request it, part of the financing for health care was initiated by the US Department of Health and Human Services. USA And it came as a surprise to the bank accounts of many healthcare providers.
Reuters interviewed six defense attorneys and others representing more than a dozen healthcare providers facing civil or criminal consultations who received the money, including a pain medicine physician who recently settled a false civil claims case and an assistance center operator who is planning to plead guilty to healthcare fraud.
“The left hand does not know what the right hand is doing,” said Joel Hirschhorn, an attorney representing the pain medicine physician and operator of the care center.
Lawyers who spoke to Reuters declined to identify their specific clients, citing confidentiality rules.
The surprise deposit of funds has led lawyers to fight to warn clients to be ready to pay back.
“There is no government windfall,” said Sam J. Louis, a former prosecutor who is now a partner in the Holland & Knight law firm, whose law firm issued an alert to clients warning them of the potential for legal liability in taking the funds.
Some former federal prosecutors say it would not have been difficult for HHS to eliminate these providers first.
“If fraudulent providers, whether convicted or under investigation, receive bailouts of the CARES Act automatically, without any background investigation, then the government’s shame,” said Paul Pelletier, a former prosecutor.
However, defense attorneys emphasized that people charged with crimes are innocent until proven guilty, and are generally not prohibited from billing Medicare until long after they have been convicted of a crime. People facing criminal health care charges generally agree to stop billing Medicare as a condition of their bonus, they added.
Another group of professionals eligible for cash infusions includes doctors who have lost their medical licenses or licenses to prescribe highly addictive drugs, said Ron Chapman, a Miami attorney.
HHS declined to say how much of the $ 30 billion went to providers facing criminal or civil investigations.
He said he distributed funds to more than 315,000 provider billing organizations that reached more than 1.5 million health care providers.
In fiscal year 2019, investigations by the HHS Office of the Inspector General led to 747 criminal actions and 684 civil actions.
(Report by Sarah N. Lynch and Marisa Taylor; Scott Malone and Daniel Wallis edition)
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