Whistleblower Lawyers for Covid-19 Uninsured Program Fraud

With over 25 years of experience, the Healthcare Fraud Lawyers at Nolan, Auerbach & White have made their mark as The Whistleblower Firm. If you’ve become aware of Covid-19 Testing Fraud including evidence that claims were falsely submitted to the U.S. Uninsured Program instead of private insurance companies, we invite you to learn more about the vital role courageous whisteblowers play in bringing justice to our healthcare system.

Call Nolan Auerbach & White at 800-372-8304 to learn more about how we guide whistleblowers through the reporting of Covid-19 fraud.


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Introduction

Shortly after Covid hit the shores of the United States, Congress passed a law, with ample funding attached to it, to make sure that ALL Americans, regardless of whether they had health insurance, would be entitled to obtain Covid tests easily and quickly.

The Program, as enacted by Congress, was called the Covid-19 Claims Reimbursement to Healthcare Providers and facilities for Testing Treatment and Vaccine Administration for the Uninsured Program (“HRSA Covid-19 Uninsured Program”). It was a great policy move and helped to get a much higher percentage of residents tested and vaccinated.

Unfortunately, its rules, regulations, and/or implementation have left much to be desired, and as such, the “uninsured” status of individuals receiving testing and vaccination has been wholly unchecked and otherwise not scrutinized by the United States.

Covid 19 Uninsured Program Fraud - The Whistleblower Firm

Program Background

“HRSA” is the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services. , Its mission is as the primary federal agency for improving health care to people who are geographically isolated, economically or medically vulnerable. Since March 2020, the Uninsured Program has provided claims reimbursement to health care providers for COVID-19 testing (as well as treatment and vaccine administration) for uninsured individuals.

The Uninsured Program is funded via (1) the FFCRA Relief Fund, which includes funds received from the Public Health and Social Services Emergency Fund, as appropriated in the FFCRA and the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA) (Pub. L. 116-139), which each appropriated funding to reimburse providers for conducting COVID-19 testing for the uninsured, and (2) the Provider Relief Fund, as appropriated in the CARES Act and the PPPHCEA.

Individuals must meet the definition of an uninsured individual (FFCRA Section 1902(ss), as amended by section 1902(a)(10)(A)(i)(VIII) of the Act); Not be enrolled in a group health plan or health insurance coverage offered by a health insurance issuer (e.g. marketplace coverage, employer-sponsored health insurance, retiree health plans, and COBRA); Not be enrolled in another health care program funded by the federal government (e.g. Medicare, TRICARE, Veterans Administration, and federal employee health plans); and not be enrolled in Medicaid.

Provider Certifications Upon Enrollment

When enrolling as a provider participant, providers were required to certify “that to the best of its knowledge, the customers identified on the claim form were Uninsured Individuals at the time the services were provided.”

Providers are required to acknowledge and did acknowledge as a condition of participation and payment in the HRSA Covid-19 Uninsured Program, that each time the provider submitted Covid test or vaccine claims for reimbursement, the provider was certifying that to the best of its knowledge, the patients identified on the claim form are uninsured individuals at the time the services were provided.

Thus, providers have the express duty to ask customers themselves if they have coverage, AND independently check for health care coverage eligibility to confirm that the customer is uninsured,.

As indications lead us to believe that multiple providers engaged in fraud by not doing so, thousands of claims submitted to the Uninsured Program were paid by the United States that should have been paid for by private insurance companies. The customers administered Covid-19 tests by certain retail pharmacy chains and other providers, did not meet the definition of an uninsured individual as required by the Uninsured Program, and, in fact, were insured by private insurance companies.

The retail pharmacy chains and other providers simply have not had systems in place to ensure that the United States does not pay for the tests and vaccinations when the individual had insurance coverage, because it has been and continues to be too easy to just submit as if the individuals are uninsured, and get paid- as simple as that.

Nolan Auerbach and White

Contact The Whistleblower Firm for Covid-19 Fraud

If you would like more information about this or other potential Covid-19 program whistleblower matters and whistleblower protection, complete this form and we will respond the same day.

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Joe told us a very troubling story about the off-label promotion of a pharmaceutical drug for patients who already suffered from chronic heart failure.

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Bruce A. Moilan Sr.

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We cannot guarantee anything, but we will deliver on this promise: we will give you feedback and a prognosis within 48 hours of your submission of all details to us. We are the first healthcare fraud qui tam law firm, and have been doing only healthcare fraud whistleblower lawsuits for decades-so you can expect as accurate a picture as is possible.

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