False Claims Policy

At Wounds Plus, we are committed to upholding the highest standards of integrity and compliance in healthcare. As a healthcare provider, we recognize our responsibility to prevent fraud, waste, and abuse in all aspects of our operations. We strictly adhere to federal and state laws and actively implement policies and procedures to detect, prevent, and address any potential violations through staff education, training, and compliance management. All employees, contractors, and agents are required to report any suspected or potential violations of fraud and abuse directly to their supervisor or the company’s compliance officer.

The False Claims Act

The False Claims Act (FCA) is a federal law that prohibits any individual or organization from knowingly submitting false information, records, or claims to a federal healthcare program. This includes any health plan or program that provides benefits funded in whole or in part by the U.S. government or a state healthcare system. Examples of false claims include:

• Billing for services not provided or not deemed medically necessary.

• Submitting multiple claims for the same service.

• Falsifying documentation to receive reimbursement for services.

• Knowingly disregarding information that a claim may be false.

Violations can occur due to intentional misconduct or negligence in verifying claim accuracy.

Civil Penalties for Violations

Under the False Claims Act, individuals or organizations that knowingly submit false claims to the government are subject to civil penalties, including:

• A mandatory penalty ranging from $5,000 to $10,000 per false claim, adjusted for inflation.

• Up to three times (treble damages) the amount of damages sustained by the government.

• Potential exclusion from participation in federal healthcare programs.

Additionally, the FCA allows private citizens to file lawsuits on behalf of the government (qui tam actions) against those suspected of committing fraud. Individuals who successfully bring qui tam actions may be eligible to receive a portion of the government’s financial recovery.

Whistleblower Protection

The FCA provides protections for employees who report suspected fraud. Employees who report violations are safeguarded from retaliation, including discrimination, harassment, demotion, suspension, or termination due to their report. If retaliation occurs, employees may be entitled to:

• Reinstatement to their position with full seniority.

• Compensation for lost wages, including two times their back pay plus interest.

• Coverage of legal fees and other damages incurred due to retaliation.

Compliance and Reporting

Wounds Plus encourages all employees and affiliates to report any concerns regarding potential violations. Reports can be made confidentially and without fear of retaliation. If you suspect fraud, waste, or abuse, please contact our Compliance Department:

Wounds Plus Compliance Department

Lehi, Utah
Phone: 385.204.4416
Email: leslie@woundsplus.com

Ensuring compliance is a shared responsibility, and at Wounds Plus, we are dedicated to maintaining transparency and ethical standards in our healthcare services.