Get ready for DOJ to come asking about COVID-19 relief programs

The federal government has prioritized prosecuting COVID-19-related fraud since the pandemic began, and recently, Attorney General (AG) Merrick Garland made clear the Justice Department’s (DOJ) commitment “to hold accountable those who seek to exploit the pandemic for personal gain.” Specifically, the focus is on COVID-19 testing for uninsured patients. Most claims submitted to the Health Resources and Services Administration (HRSA)—which administers the provider relief fund that reimburses eligible providers for COVID-related expenses for uninsured patients—are legitimate. But tens of thousands could be considered frivolous under the False Claims Act or the antikickback statute. No matter which law may apply, if you invoiced the HRSA, you should expect a civil investigative demand (CID) and consider the following steps.

Investigation begins

The government serves a CID when it believes a person or entity may be in possession, custody, or control of documentary material or information relevant to a False Claims Act or antikickback statute investigation.

A CID is an administrative subpoena that allows federal agencies to request an extraordinary amount of information from private entities without formal court procedures. It’s a powerful tool that allows the government to demand the production of certain documents while also demanding detailed explanations of the entity’s COVID-19 procedures.