Vault Agrees to Pay $8 Million to Settle Allegations of Fraudulent COVID-19 Claims

Key Takeaways

• Vault Settlement: Vault Medical Services has agreed to pay $8 million to settle allegations of submitting false claims to the COVID-19 Uninsured Program for insured patients.
• False Claims Act Violation: The company allegedly submitted claims for patients who had health insurance, violating the False Claims Act between May 2020 and April 2022.
• Insurance Verification Issues: Vault failed to verify insurance information for patients and disregarded valid insurance details before submitting claims to the program.

Deep Dive

Vault Medical Services has agreed to pay $8 million to resolve allegations that the company violated the False Claims Act by submitting fraudulent claims to the HRSA COVID-19 Uninsured Program. This program was meant to assist uninsured individuals with testing, treatment, and vaccines during the pandemic.

From May 2020 to April 2022, Vault provided COVID-19 testing and vaccine services, both via telehealth and at in-person sites. However, the company allegedly submitted claims to the Uninsured Program for patients who actually had health insurance. The core issue? Vault’s failure to properly verify insurance coverage for patients, despite having insurance information available. This failure led to claims being submitted to the program that were not entitled to reimbursement, diverting essential funds meant for the uninsured.

U.S. Attorney Alina Habba didn’t hold back, “The Uninsured Program provided critical support for testing and treatment for uninsured Americans during the height of the pandemic. Our office will not tolerate the alleged fraud, abuse, and waste of these funds.”

While Vault’s services were critical during the pandemic, the company was accused of knowingly submitting claims for insured patients. The government alleges Vault was aware of the issues with patient data, including insurance information, but failed to properly address the discrepancies. Even when they had verified insurance details, Vault allegedly disregarded these details and submitted false claims to the Uninsured Program, an act that, according to the government, jeopardized funds meant to help those most in need.

Naomi Gruchacz, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General, added, “Individuals and entities that participate in the federal healthcare system are required by law to preserve the integrity of program funds. The settlement in this case involves a provider that knowingly sought reimbursement for federal funds to which they were not entitled, and by doing so jeopardized the provision of services for the uninsured.”

Vault has agreed to pay the $8 million to resolve these allegations, but has not admitted to any wrongdoing. The settlement brings an end to the investigation, and while Vault is moving forward, the responsibility healthcare providers have when it comes to the integrity of public funds is front of mind.

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