What responsibility does a Brightstar Care franchisee have to screen employees for excluded status in Medicare, Medicaid, or other payment programs?
Brightstar_Care Franchise · 2025 FDDAnswer from 2025 FDD Document
ry penalties. Alleged violations of the fee-splitting laws have also been used successfully by health care professionals to declare a contract to be void as against public policy.
e. Other Federal Regulations
For providers participating in Medicare or Medicaid, there are comprehensive requirements related to such participation in addition to those found in their provider agreement. There
are a number of federal laws prohibiting certain activities and arrangements relating to services or items which are reimbursable by Medicare or Medicaid. Even though your Agency is prohibited by its Franchise Agreement from participating in Medicare, it may from time to time provide staff to other facilities, including those that participate in the Medicare and/or Medicaid programs. While Medicare laws may not apply to your Agency, these laws may apply to those facilities, including laws prohibiting Medicare- or Medicaid-participating facilities from employing providers excluded from those programs. If a practitioner is an excluded provider from Medicare or Medicaid, he or she will be prohibited from receiving payment from that facility. It is your responsibility to determine whether and to what extent employees of your Agency need to be screened for their possible excluded status in these or other payment programs.
To the extent your franchise accepts reimbursement directly from the VA, it will be required to satisfy the applicable regulatory requirements the VA imposes on its vendors, including but not limited to the Federal Acquisition Regulations and various VA contract requirements. The False Claims Act imposes civil liability on persons or corporations which submit or cause to be submitted false or fraudulent claims for payment to the government. A violation of the False Claims Act may result in liability for fines, treble damages, attorneys' fees, and exclusion from federal health care programs.
F.
Source: Item 23 — RECEIPTS (FDD pages 118–387)
What This Means (2025 FDD)
According to Brightstar Care's 2025 Franchise Disclosure Document, franchisees have a responsibility to screen employees for excluded status in Medicare, Medicaid, and other payment programs. While Brightstar Care agencies are prohibited from directly participating in Medicare, they may provide staff to facilities that do participate in these programs. Therefore, it is the franchisee's responsibility to determine the extent to which their employees need to be screened for excluded status.
This requirement is crucial because facilities participating in Medicare or Medicaid are prohibited from employing providers excluded from those programs. If a practitioner is excluded, the facility cannot receive payment for their services. This places the onus on Brightstar Care franchisees to ensure compliance to avoid potential legal and financial repercussions for the facilities they serve.
Furthermore, if a Brightstar Care franchise accepts reimbursement directly from the VA, it must adhere to the VA's regulatory requirements, including the Federal Acquisition Regulations and various VA contract requirements. The False Claims Act imposes liability for submitting false claims to the government, which can result in fines, treble damages, attorneys' fees, and exclusion from federal health care programs. Brightstar Care franchisees are responsible for staying informed about changes in legislation that may impact their agency's operations and are strongly urged to consult with legal counsel regarding applicable laws and regulations.