February 9, 2021 | less than a minute read

Wave of Whistleblower Complaints and Subsequent Enforcement Under the False Claims Act Likely Says Top Health Atty

Taylor English

Qui tam complaints are poised to make a strong appearance this year as instances of fraud in nursing homes and the telehealth field are brought under the "worthless services" theory, which some courts have upheld. As explained by the Seventh Circuit in U.S. ex rel. Absher v. Momence Meadows Nursing Center, Inc., filing a successful lawsuit under this worthless services theory requires evidence to show that the facility or practitioner’s services were of absolutely no value, not just diminished value.

...I think that some whistleblowers might pursue what you are invoking: a worthless services theory, which some courts have upheld. [The idea] is that if services are viewed as so deficient that they are worthless, then the billing claim submitted to the government for those services is viewed as a false claim. And so the theory would be that if a nursing home or skilled nursing facility didn't do enough to prevent or contain a COVID-19 outbreak, and that led to illness among a number of beneficiaries, then services being provided during the time that led to their illness would be viewed as worthless. That is one theory whistleblowers might try to pursue.