Vault Medical Services Settles $8M False Claims Act Allegations for COVID-19 Billing

Vault Medical Services, P.A. and Vault Medical Services of New Jersey, P.C. agreed to pay $8 million to the U.S. government to resolve allegations of violating the False Claims Act by submitting false claims to the Health Resources & Services Administration’s COVID-19 Uninsured Program. This program reimbursed providers for COVID-19 testing, treatment, and vaccine administration services provided to uninsured individuals during the public health emergency between May 2020 and April 2022. Vault allegedly submitted claims for services performed on patients who actually had active health insurance, which disqualified them from this program.

The allegations include Vault’s failure to maintain data integrity at the point of service, particularly the incomplete collection of patient demographic and insurance information. Vault did not adequately confirm patients’ insurance status and submitted claims to the program despite having insurance information on file for many individuals. These actions resulted in improper reimbursement from federal funds designated for the uninsured.

This settlement highlights the federal government’s ongoing efforts to combat fraud and abuse within healthcare programs, particularly those established during the COVID-19 pandemic. It underscores the importance of compliance with data collection and insurance verification requirements to preserve the integrity of federal health programs and ensure funds are allocated properly.

The resolution was achieved through coordination between the U.S. Attorney’s Office for the District of New Jersey, the Justice Department’s Civil Division Fraud Section, and the Department of Health and Human Services Office of Inspector General. The case exemplifies the use of the False Claims Act as a deterrent to fraudulent billing practices in federally funded healthcare programs.

Providers participating in federal healthcare programs are reminded of their legal obligation to uphold accurate billing and documentation standards. The government continues to encourage reporting of suspected fraud to maintain program integrity and protect taxpayer funds. The settlement does not determine liability but resolves allegations of fraud related to COVID-19 reimbursement claims.