In the Matter of the Surveillance and Integrity Review (SIRS) Appeal by Nobility Home Health Care, Inc. A21-1477, ...

Syllabus

1. The meaning of \abuse\ in Minnesota Statutes section 256B.064 (2022), includes the failure to maintain health service records as required by law and submitting claims for services for which underlying health service records are inadequate, even if the person did not seek to deceive the Department of Human Services. Accordingly, the portions of Minnesota Rule 9505.2165 (2021) defining such conduct as \abuse\ do not 1 conflict with the statute and such conduct may be grounds for sanctions under Minnesota Statutes section 256B.064, subdivision 1b, and monetary recovery under Minnesota Statutes section 256B.064, subdivision 1c. 2. Given the lack of analysis and inadequate record below, we decline to interpret or apply the phrase \improperly paid . . . as a result of\ abuse contained in section 256B.064, subdivision 1c—which governs the grounds for monetary recovery—and we remand to the Department of Human Services to permit further evidence to be taken or additional findings to be made in accordance with the applicable law. Reversed and remanded.