Home Health & Hospice Week

Threat of FCA lawsuits causes providers to settle. There's a troubling new trend growing -- the government's use of the False Claims Act as a hammer for collecting settlements from providers -- and you could be the next target. In a letter this fall to U.S. Attorney General Eric Holder Jr. and HHS Secretary Kathleen Sebelius, the American Hospital Association addressed the problem. The group asks the cabinet-level Health Care Fraud Prevention and Enforce-ment Action Team to do a policy review of FCA initiatives currently underway. The False Claims Act doesn't apply to "billing errors, mistakes or even nonculpable overutilization," as the Department of Justice explained to Congress related to amendments expanding the FCA's authority to pursue violations, AHA points out in its correspondence. Yet the government is initiating "aggressive FCA investigations" when it uncovers evidence of a mistake or overutilization. This makes "FCA enforcement through negotiated 'settlement' a self-fulfilling prophecy," [...]