Bill could lead to more False Claims prosecutions

A bill aimed primarily at fighting mortgage fraud may also end up broadening the scope of claims that can be pursued under the False Claims Act, the law under which many prosecutions for Medicare fraud are conducted.

The bill would extend the False Claims Act to include false or fraudulent claims for government money or property, even if the claims aren't presented to a government official or employee. It would also extent such prosecutions to situations where the U.S. government never had physical custody of the money.

Perhaps the toughest change is that the government won't have to prove that the defendant intended to defraud the U.S. government. The violator would only have to have had knowledge of information that a claim might be false, acted deliberately without verifying the information, or acted in reckless disregard of the truth or falsity of the information.

As it is, the government recovered more than $15 billion using prosecutions under the False Claims Act from 2000 to 2008. These provisions could give CMS some powerful additional tools for collecting fraud claims. 

Not surprisingly, providers are already worrying how they can defend themselves when the government no longer has to prove intent to commit fraud. We'll see how that shakes out if the bill becomes law, but I doubt it will be pretty.

To find out more about this bill:
- read this Health Leaders Media piece

Related Articles:
Federal False Claims act uses narrowed, but legislators still want expansion
NJ hospitals face false-claims charges
St. Barnabas to pay $265 million for Medicare fraud

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