As an addendum to our recent article titled “Nursing care quality and the False Claims Act” in the June issue of Long-Term Living, the Office of Inspector General unveiled a new webpage last month dedicated solely to quality-of-care Corporate Integrity Agreements, called CIAs hereafter.
|Jason E. Bring, Esq.|
When a False Claims Act (FCA) settlement resolves allegations of fraud that involve the quality of patient care, the OIG often enters into a CIA with the provider. The OIG negotiates CIAs with healthcare providers as part of settlements of federal healthcare program investigations arising under various civil false claims statutes. The providers agree to the obligations in the CIA and the OIG agrees not to seek their exclusion from participation in Medicare, Medicaid or other federal healthcare programs.
Specifically, a quality-of-care CIA requires the provider to retain an independent quality monitor who will address the specific issues alleged in the FCA action along with the provider’s overall ability to respond to patient care problems. When a provider enters into a quality-of-care CIA as part of a settlement, however, it is not an admission that it provided substandard patient care. In fact, the OIG website advises that the presence of a quality-of-care CIA is neither indicative of the quality of care at the provider's facility nor is it a guarantee of adequate patient care going forward. The OIG is instead recommending that the public utilize Nursing Home Compare as a tool to obtain a facility’s quality-of-care information.
The new OIG webpage contains a central listing of all current quality-of-care CIAs, including many from skilled nursing facilities, which providers have entered into as part of FCA settlements. The website also offers links to government press releases regarding these settlements.
Jason E. Bring, Esq., is a member of the Healthcare Group of Arnall Golden Gregory LLP. Bring defends nursing facilities in medical liability and False Claims Act cases, as well as assists them in regulatory and reimbursement issues.