DOL Compliance & Defense for Nuclear Home Care Providers
DOL Nuclear Home Care Counsel for Providers Nationwide
DOL Compliance Team Lead
Founding Attorney
Medical providers and skilled nursing providers that provide in-home care for patients affected by working with uranium or nuclear weapons can rely on U.S. Department of Labor (DOL) programs to cover the costs of many of the items and services they provide. However, when doing so, they must be extremely careful. Improperly billing these programs and improperly billing patients or their loved ones for providing assistance with enrolling in these programs can lead to DOL enforcement actions—and these enforcement actions can lead to steep penalties.
At Oberheiden P.C., we assist nuclear in-home care providers with managing compliance under the Employees Occupational Illness Compensation Program Act (EEOICPA) and Radiation Exposure Compensation Act (RECA). We also defend nuclear in-home care providers accused of abusing the claims process under these (and other) federal laws. Accusations of falsely claiming eligibility or improperly billing for costs can have serious consequences, and we rely on our experience to help nuclear home healthcare providers avoid these consequences whenever possible.
DOL Nuclear Home Care Compliance
We provide comprehensive compliance representation for home healthcare providers that bill the DOL for services provided to uranium workers and others diagnosed with the effects of toxic exposure under the EEOICPA. We provide comprehensive compliance representation for providers that assist with the RECA application process as well. Our compliance services in this area include:
Energy Employees Occupational Illness Compensation Program Act (EEOICPA) Compliance
The Employees Occupational Illness Compensation Program Act (EEOICPA) is a federal law that entitles eligible claimants to medical benefits for approved illnesses linked to working with nuclear weapons or uranium. These benefits cover qualified home and residential healthcare services, including: (i) home health care; (ii) care in skilled nursing facilities; (iii) care in assisted living facilities; and, (iv) hospice care.
Some examples of conditions that can qualify as an “approved illness” under EEOICPA include:
- Beryllium sensitivity
- Chronic beryllium disease
- Chronic silicosis
- Cancers linked to uranium exposure
- Other “consequential conditions”
However, even if a home healthcare provider treats a survivor or another patient with an approved illness, the provider must still do much more before it can file an EEOICPA claim as an authorized representative and seek payment from the DOL. Effectively managing EEOICPA compliance requires a comprehensive and custom-tailored approach, and we are available to work with providers across the country to assist with both maximizing their ability to bill under EEOICPA and maximizing their ability to demonstrate compliance to the DOL when necessary.
Energy Employees Occupational Illness Compensation Program Compliance
The Energy Employees Occupational Illness Compensation Program is the DOL’s mechanism for paying the benefits authorized by the EEOICPA. It currently covers new claims filed under Part B and Part E for eligible patients who have an EEOICPA White Card.
The benefits that uranium workers and other eligible patients can access under the Energy Employees Occupational Illness Compensation Program depend on their level of impairment, wage loss (based on employment history), age, and other factors. As a result, nuclear home health providers must be extremely careful to ensure that they accurately bill the DOL on a case-by-case basis. Here too, we assist our clients with the development of custom-tailored compliance policies and procedures, and we maintain ongoing communication with our clients so that our clients can get the insights they need when they need them.
Radiation Exposure Compensation Act (RECA) Compliance
The Radiation Exposure Compensation Act (RECA) is a federal law that provides benefits to qualifying individuals who experienced exposure to radiation through the U.S. nuclear weapons program and their survivors. The One Big Beautiful Bill (OBBB) reauthorized filing claims under RECA through 2027, and it also expanded the eligibility criteria for seeking financial support under the statute.
Some nuclear home health providers assist their patients with seeking the benefits they deserve under RECA. However, this also comes with legal risks. In particular, if providers charge a fee for helping patients and families file RECA claims, this can lead to fraud charges under federal law.
DOL Nuclear Home Care Defense
We also provide comprehensive defense representation for nuclear home healthcare providers that are facing scrutiny from the DOJ and other federal authorities. This scrutiny can involve a wide range of allegations, and it can expose providers (both individuals and entities) to administrative, civil, and/or criminal penalties.
Some examples of potential allegations in federal investigations and enforcement proceedings involving home health services provided under EEOICPA and RECA include:
- Billing the DOL under EEOICPA without meeting all eligibility requirements
- Billing the DOL under EEOICPA for treating conditions other than approved illnesses
- Billing for nuclear home health services provided by unqualified personnel
- Billing for nuclear home health services that do not qualify as “medically necessary”
- Using patients’ EEOICPA White Cards to bill for items or services not provided (phantom billing)
- Improperly charging fees for assisting patients or families with securing EEOICPA or RECA benefits
- Offering or accepting referral fees, kickbacks, or other illegal payments in exchange for EEOICPA or RECA patient referrals
These violations (among others) can lead to prosecution under the False Claims Act and other federal statutes. The False Claims Act prohibits submitting any false or fraudulent claim for payment under any federal benefit program and using program-reimbursed funds to pay referral fees or kickbacks. In recent years, we have seen the U.S. Department of Justice (DOJ) pursue multiple multi-million-dollar enforcement cases under the False Claims Act related specifically to improper billings under EEOICPA.
Why to Choose Oberheiden P.C. for Nuclear Home Health Compliance and Defense
If you have questions or concerns about nuclear home health compliance, why should you choose the team at Oberheiden P.C.? Here are just some of the ways we make a difference for our clients:
- Understanding the Legal Risks Involved – Many nuclear home health providers do not realize the risks involved in billing for services under EEOICPA and RECA. We help our clients understand these risks so they can make informed and strategic decisions.
- Managing the Legal Risks Involved – We provide our clients with custom-tailored compliance solutions focused on helping them manage the legal risks they face under EEOICPA and RECA on an ongoing basis.
- Open and Regular Communication – We work with many of our healthcare clients on an ongoing basis. By communicating with our clients regularly, we are able to help them avoid potential mistakes before they lead to trouble with the DOL or DOJ.
- Comprehensive Federal Healthcare Compliance Services – Beyond nuclear home health compliance, we provide assistance with all other aspects of federal healthcare compliance as well. This includes (but is not limited to) billing compliance under all other federal benefit programs.
- Emergency Representation When Necessary – While we prioritize helping our clients avoid federal scrutiny whenever possible, we also know that providers cannot fully insulate themselves from the risk of facing federal inquiries. We are available to provide emergency representation to both new and existing clients when necessary.
FAQs: Compliance and Defense for DOL Nuclear Home Care Providers
When Can Nuclear Home Health Providers Bill for Medical Benefits Under EEOICPA?
Nuclear home health providers can bill under EEOICPA when they provide qualifying services to eligible patients with approved illnesses. With that said, the fact that a patient has an EEOICPA White Card does not necessarily mean that billing the DOL is warranted. Instead, providers must assess their ability to bill the DOL on a case-by-case basis.
Does the EEOICPA Cover Nuclear Home Health Services Provided to Workers’ Family Members or Other Loved Ones?
The EEOICPA covers nuclear home health services provided to qualifying family members. Here too, whether billing under Part B or Part E, nuclear home health providers must ensure not only that billing is authorized, but that they have the documentation they need to prove authorization if necessary.
Can Failing to Provide High Quality Care or Compassionate Care Lead to Enforcement Under EEOICPA?
Like all federal healthcare benefit programs, the Energy Employees Occupational Illness Compensation Program requires nuclear home health providers to deliver medically necessary services in line with the applicable standard of care. As a result, providing substandard care (or providing care delivered by unqualified individuals) can lead to enforcement action under EEOICPA.
What Are the Risks of Improperly Billing the DOL for EEOICPA Benefits?
Improperly billing the DOL for EEOICPA benefits can lead to enforcement action under the False Claims Act and other federal laws. Depending on the nature of the allegations involved, this enforcement action could be either civil or criminal in nature. Nuclear home healthcare providers can face loss of DOL eligibility and other administrative penalties as well.
What Are the Risks of Improperly Billing for Providing Assistance with Obtaining RECA Benefits?
Improperly billing for providing assistance with obtaining RECA benefits presents similar risks. Fines are on the table in all cases, while allegations of intentionally defrauding the federal government or patients dealing with the consequences of uranium exposure could lead to federal prison time.
Speak with an Attorney at Oberheiden P.C. in Confidence
If you need to know more about DOL compliance or defense related to nuclear home health care, we invite you to get in touch. To speak with a senior attorney at Oberheiden P.C. in confidence, please call 866-680-1745 or request a complimentary consultation online today.
