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Task Forces in 10 States Target Providers of Services to Elderly

On March 30, 2016, the US Department of Justice (DOJ) announced that healthcare providers who serve the elderly in the following 10 states will have task forces looking over their shoulders: California, Georgia, Kansas, Kentucky, Iowa, Maryland, Ohio, Pennsylvania, Tennessee and Washington. Known as the Elder Justice Task Forces (Task Forces), these partnerships combine the resources of “federal, state and local prosecutors, law enforcement, and agencies that provide services to the elderly,” with an eye toward “coordinat[ing] and enhanc[ing] efforts to pursue nursing homes that provide grossly substandard care to their residents.” DOJ indicated that the Task Forces “reflect the department’s larger strategy and commitment to protecting our nation’s seniors, spearheaded by the department’s Elder Justice Initiative.”

What Practices and Providers Will the Task Forces Target?

As mentioned above, the Task Forces will focus on nursing home violations. However, in a subsequent interview, a DOJ spokeswoman indicated that nursing homes could be just the beginning, explaining it was “certainly possible that [the Task Forces] may look into concerns or allegations involving other types of long-term care providers if they fall within the team’s region or jurisdiction.” The spokeswoman made clear that “[r]egardless of the provider type, the [T]ask [F]orces will take appropriate action if violations of law are identified.”

Providers should prepare to face increased scrutiny whenever they serve elderly patients because of (1) the Task Forces’ placement within the DOJ’s broader Elder Justice Initiative, (2) the combination of federal and state laws that the Task Forces’ various members are empowered to enforce and (3) DOJ’s post-announcement statement that the Task Forces will proceed “regardless of provider type.” Bases of liability will likely include the False Claims Act (when a provider bills Medicare or Medicaid for services that are either so defective as to be effectively worthless or medically unreasonable and unnecessary), HIPAA (for disseminating certain patient information such as via social media) and state criminal law (for sexual abuse, assault and failure to report other criminal acts perpetrated against elderly patients).

Every Provider Needs to be Concerned

The 10 districts were not chosen at random, as several – including the Southern District of Ohio and Eastern District of Pennsylvania – have previously been involved in DOJ-led efforts to pursue elder care providers who seek to defraud their patients and federal programs. In addition to criminal penalties and civil fines, other sanctions are available. In previous elder abuse cases, HHS’s Office of Inspector General (OIG) required onerous, multi-year Corporate Integrity Agreements and mandatory, independent quality monitors. Given the success of DOJ-led task forces such as the Health Care Fraud Prevention and Enforcement Action (HEAT) Task Force, providers of healthcare services to the elderly should be especially mindful of the importance of strict compliance with federal and state law, including those mentioned above.

© Copyright 2019 Squire Patton Boggs (US) LLP


About this Author

Thomas E. Zeno, Squire Patton Boggs, Healthcare Fraud Lawyer, Economic Crimes Attorney
Of Counsel

Thomas Zeno has more than 25 years of experience in the US Attorney’s Office for the District of Columbia. During that time, Tom investigated and prosecuted economic crimes involving healthcare, financial institutions, credit cards, computers, identity theft and copyrighted materials. As the office’s Healthcare Fraud Coordinator for the last eight years, Tom supervised investigation strategies of agents from the Federal Bureau of Investigation, the Department of Health and Human Services, the Drug Enforcement Administration and the Medicaid Fraud Control Unit regarding...

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Robert Nauman, Health Care, Lawyer, Squire Patton Boggs

Robert has extensive experience counselling healthcare clients, including hospitals and health systems, physicians, physician groups, ambulatory surgery centers, insurers, health plans and management companies, in a variety of regulatory and transactional matters.

Robert’s areas of expertise include healthcare fraud and abuse laws, Medicare reimbursement issues, provider alignment strategies, provider enrollment, accreditation and licensure, Accountable Care Organizations, provider acquisitions and affiliations, healthcare antitrust matters, insurance regulation and healthcare transactional matters.

He is a member of the Ohio State Bar Associations and the American Health Lawyers Association.

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James Hafner Health Care Lawyer Squire Patton Boggs Cleveland

James Hafner advises clients in industries ranging from manufacturing and medical technology to financial services, healthcare and insurance on a variety of corporate matters, including mergers and acquisitions, governance, contracts, securities and related matters. In addition to his work as a corporate lawyer, he previously worked as in-house counsel for one of the world’s leading hospital systems.

His transactional and regulatory experience includes negotiating physician practice acquisitions and employment contracts, providing guidance on...

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