Medicare Compliance & Reimbursement

Find out how this statute creates an uneven playing field that recently got bigger. Finding out that you're the target of a False Claims Act investigation is likely high on most providers' worry lists these days -- and for good reason. Below legal experts provide a run-through of why this statute can be problematic. No. 1. The cards are stacked in prosecutors' favor. FCA cases give the government leverage that they don't have in typical civil litigation, observes attorney Antonia Giuliana, with Kelley Drye & Warren in New York, N.Y. "For example, many FCA investigations are settled before the case is unsealed and the litigation even starts." This gives the government the chance to conduct "one-sided discovery" on providers who aren't allowed to do the same with the government until the case is unsealed and initiated, she explains. Also: Providers are always concerned that while they can put up a "meritorious [...]