What’s New in Health Law
No FCA Liability for Inappropriately Promulgated Rules
The United States District Court for the Eastern District of Pennsylvania granted the Government’s Motion to dismiss a qui tam False Claims Act (“FCA”) that was based on an allegation that the defendant caused its hospital clients to inappropriately and fraudulently bill hundreds of thousands of outpatient claims as inpatient claims, resulting in overpayments to the hospitals. In a relatively lengthy opinion that discussed at length whether the government had the right to demand the dismissal of the relator’s claim, the court took the time to note that the defendant could not possibly be held liable under the False Claims Act for causing hospitals to bill outpatient claims as inpatient claims even though they did not meet the two-overnight rule because the two-overnight rule was not promulgated with notice and comment, as required by the Medicare Act.
Polansky v. Exec. Health Res., Inc.
To read more about this case and more, visit our What’s New page
Question of the Week
Is there any way to ensure that practitioners at our hospital keep patients within the community and don’t unnecessarily transfer them to other facilities for the practitioners’ convenience or profit, without going through all of the rigamarole of summarily suspending the physician and then revoking his appointment and privileges, as in the Patel case that is featured in the “NEW CASES” section of this week’s Health Law Express?
Read the answer>>
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