Morning Briefing
Summaries of health policy coverage from major news organizations
Industry Groups Hopeful That False Claims Act Whistleblower Cases Will Dwindle Under New Attorney General
Modern Healthcare: New Justice Dept. Policies, AG May Mute False Claims Act Whistleblowers
Healthcare industry groups have always hated False Claims Act whistleblower lawsuits. These cases involve private individuals—usually knowledgeable insiders—accusing companies and individuals of defrauding federal programs in the hope of righting a wrong and collecting a share of the bounty for their work. False Claims Act lawsuits can hit companies and individuals with damages up to three times the demonstrated losses to the government. Whistleblowers can pocket 15% to 30% of that recovery. The number of healthcare cases grew to 506 in 2018 from 291 in 2008. (Meyer, 2/16)
Modern Healthcare: Can A Doctor's Medical Necessity Decision Be A False Claim?
Last year, Intermountain Healthcare lost an appeal to dismiss a whistleblower case accusing it, HCA-owned St. Mark's Hospital and a staff cardiologist of filing false Medicare claims for nearly 1,000 medically unnecessary heart operations. On Jan. 14, Intermountain petitioned the U.S. Supreme Court to decide whether part of the whistleblower law violates a constitutional clause barring individuals not appointed by the president, the attorney general or the federal courts from prosecuting cases on behalf of the government. It wants to stop the case from moving to discovery. (Meyer, 2/16)
