Breaking Compliance News Blog

Your Employees' Tax Delinquencies Could Mean False Claims for You

Posted by Margaret Scavotto, JD, CHC on 4/22/14 5:46 PM

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Nurses who fail to pay their state taxes or student loans could have their state licenses pulled--at least that is the case in Missouri. Why should their employers care about this? Because Medicare and Medicaid won't pay for the services of an unlicensed nurse. That's right, claims billed for these services constitute false claims--and could cost a nursing home hefty penalties (repayment of 3 times the amount of the claim, plus $11,000 per claim, plus the SNF could become excluded from participating in Medicare and Medicaid).

Employers aren't the only parties at risk. Nurses who practice without an active license are also violating the law and could face penalties and further license implications.

Your compliance program's employee screening policies and procedures should help prevent these false claims:

  • Verify all nurse licenses with the state--do not rely on documentation provided by the employee
  • Conduct this verification at hire and annually (or use a software solution that updates nightly)
  • Educate employees to understand they have a duty to notify the SNF if their license becomes implicated

While these practices will reduce your chances of employing a nurse without an active license, there is still cause for concern. Nurses understandably fear risking their jobs by coming forward and reporting that their license is in jeopardy. Dr. Kendall Brune, PhD, MBA, LHNA, FACHCA, health care strategist, suggests that SNFs consider working out a payment strategy for a nurse to pay these obligations. This would, after all, be a lot less costly than False Claims Act penalties. By explaining to employees that extensive OIG penalties are on the line, and that the SNF is willing to help nurses who find themselves in this situation, a SNF can increase their chances of avoiding a false claims debacle.

As Dr. Brune says, "This issue is not a new issue, but the OIG penalties are a game changer!"

For more information on how to reduce compliance risk with effective employee screening practices, see MPA's website.


Topics: Breaking Compliance News Blog, Penalties and Enforcement

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