Cracking Down On Nursing Home Fraud And Abuse In California
Creation Of Operation SAFE (Stop Abuse and Fraud of Elders)
Inspection Program To Target Fraud And Elder Abuse
California State Attorney General Xavier Becerra, President Biden’s pick to lead the Department of Health and Human Services, before leaving his post as California Attorney General created a surprise inspection program known as Operation SAFE, to be led by a new state-level Department of Justice division (DMFEA, or Division of Medi-Cal Fraud and Elder Abuse) targeting Medi-Cal fraud and elder abuse. DMFEA and Operation SAFE recognize that Medi-Cal fraud often overlaps with elder abuse in nursing homes and assisted care facilities. Evans Law Firm, Inc. represents California seniors who have suffered elder abuse and individuals with credible information of fraud against government-sponsored healthcare programs like Medi-Cal. Individuals with information of Medi-Cal fraud can bring actions on behalf of the State of California known as “qui tam” actions and those individuals can be rewarded for bringing qui tam cases if the government recovers. See Cal. Gov’t Code § 12650 et seq. (California False Claims Act). If you have credible information of fraud against the government including under Medicare, Medi-Cal or other government programs, or if an older loved one has been the victim of elder abuse in a care facility or at home under the care of an in-home caregiver, call the Los Angeles and California whistleblower attorneys at Evans Law Firm, Inc. today at (415) 441-8669.
DMFEA and Operation SAFE
The DMFEA will expand the state’s Medi-Cal fraud and elder abuse enforcement abilities by sending teams of “agents and medical professionals” into Medicaid-funded nursing homes to investigate claims of abuse and neglect under Operation SAFE, according to the California Department of Justice. In creating DMFEA, Attorney General Becerra noted the fact that 34% of California coronavirus deaths occurred in the state’s nursing. DMFEA will continue its mission of investigating and prosecuting fraud committed against the Medi-Cal program as well as physical or financial abuse or neglect of elders and dependents in care facilities statewide. As part of this effort, Attorney General Becerra launched Operation SAFE (Stop Abuse and Fraud of Elders), an initiative aimed at further protecting elders and Californians living in skilled nursing facilities during the pandemic.
Patients and employees may have information of abuse and government fraud. Our attorneys will pursue all available remedies to any plaintiffs injured by abuse or impacted by fraud. If you are an employee with information of Medi-Cal fraud, State law protects you from retaliation by your employer from bringing a qui tam case. Cal. Gov’t Code § 12653. Our litigators can represent you in any suit for wrongful retaliation by your employer as well as in your underlying qui tam action blowing the whistle on the fraud.
Recent Examples of Medi-Cal Fraud
The California Department of Justice has recently settled several large Medi-Cal fraud cases which illustrate various types of Medi-Cal and Medicare fraud the State polices. Examples include:
- $1 Million Settlement with a Post-Acute Rehabilitation Center: DMFEA secured a $1 million settlement with a post-acute rehabilitation center resolving allegations that defendants wrongly billed Medi-Cal for patients needing a heightened level of skilled nursing care and failed to provide the minimum number of nursing hours for its subacute care unit in violation of State requirements.
- $18.9 Million Settlement with Large Health Care Network: California and federal agencies worked together to reach a settlement with the network after the network self-disclosed that it overcharged Medi-Cal for certain drug reimbursement claims.
- $9.5 Million Settlement with Pharmacy: A $9.5 million settlement with a large national pharmacy chain resolving allegations that the drugstore chain offered incentives to beneficiaries to lure them into its prescription drug program and overcharged Medicare and Medicaid programs in filling the prescriptions.
Ingrid M. Evans and the other Los Angeles whistleblower and elder abuse attorneys at Evans Law Firm can be reached at (415) 441-8669, or by email to <a href=”mailto:firstname.lastname@example.org”>email@example.com</a>. Reporting fraud or elder abuse to the authorities is important but also reach out to counsel to pursue all available remedies. Whether your case is about fraud against the government or the abuse of an older loved one, Ingrid and our other Los Angeles litigators can help.
 Evans Law Firm, Inc. was not involved in any of these cases in any way.