Litigating False Claims Act Cases and Other Civil Matters Involving Assertions of Hospital or Physician Misconduct

As most hospitals are aware, the Federal False Claims Act (FCA) allows individuals (relators) to bring civil actions in federal court on behalf of the relator and the Federal government for alleged violations of the substantive provisions of the FCA. These actions are in addition to  other civil and criminal sanctions available to the Federal government.  Such violations typically involve alleged liability for knowingly presenting false or otherwise deficient claims for Medicare, Medicaid or other government program reimbursement. Claims have been found to be false when the healthcare services provided were medically unnecessary, contravened various regulations or when the quality of medical care provided was substandard. Several courts have also allowed claims alleging false certifications by hospitals and other providers of compliance with Medicare anti-kickback and self-referral rules. FBT attorneys have represented hospitals and physicians in such cases in Federal and State courts.