This case caught my attention back in March as it raises issues that I commonly hear about namely, staffing agency costs and possible abuses in terms of actual time worked v. time billed by the agency. My March post is available here: https://rhislop3.com/2024/03/28/skilled-nursing-operator-takes-legal-action-against-staffing-platform-for-alleged-overbilling/
Nursa, an electronic staffing application company based in Utah, filed a lawsuit against Oxford Valley Health in the US District Court, demanding payment for bills that had accumulated for just over a year. The amount includes $4.2 million for nurse placement fees and approximately $781,000 in late fees, with interest still accruing.
Oxford Valley countered with a claim of its own, stating that the software-based staffing agency failed to uphold its end of a contract by billing for shifts in which “a substantial portion … did not have any clock in/out records, or any other form of documentation to substantiate that the clinician performed the work during the invoiced shifts.” Provider sues agency for routine overbilling, unscrupulous practices that led to $5M bill
This summer, Nursa asked the court to dismiss Oxford’s claim stating that Oxford should have challenged the “billing inaccuracies” within the time prescribed by the agreement. In a crazy twist (at least crazy to me), Nursa argued that nothing in its agreement with Oxford prevented it (Nursa) from charging for services that were not rendered (seems rather fraudulent).
The judge from the US District Court for Utah rejected Nursa’s attempt to blame the provider. She cited the agreement that required Nursa to document the Job ID, clinician name, start time, end time, break length, hours worked, billing rate, and total amount billed. Nursa has stated that this documentation “will accurately reflect completed and verified (manual or auto) shift reports” from its app.
Per the Judge’s statement, “Assuming this allegation is true, as the Court must at this stage, Nursa failed to ‘document … start time, end time, break length (if any) [and] total hours worked … as it had agreed to do. The Counterclaim alleges Nursa billed for services in the absence of time records or other documentation to show any clinician worked a shift. Thus, rather than billing based on documentation that ‘accurately reflect[s] completed . . . shift reports,’ Nursa allegedly billed on some other basis.”
The case will now move on to the discovery phase. As I originally wrote in March, it will be interesting to see if this case does morph into a class action suit as Oxford has intonated. An attorney for Oxford has previously stated (publicly), it (Oxford) was bringing the case as a class action because “we, like so many others, feel taken advantage of by the likes of Nursa, who threatened to, and then did, cut off our access to their service once we raised our concern about substantial overbilling”.
One of the concerns Oxford Valley highlighted was the staffing application’s implementation of a 48-hour window for billing review. Any bills not contested within this timeframe were deemed to have been automatically verified by the staffing firm. Oxford argued that the $4.2 million in bills was inflated, which means Nursa “knew, or should have known, that it was demanding payment from Oxford for healthcare services that were not performed.”