Friday, June 17, 2016

DOJ Appeals AseraCare Case

Dianne De La Mare 

The US Department of Justice (DOJ) filed a notice that it is appealing a federal judge's order that dismissed a whistleblower lawsuit claiming that hospice provider, AseraCare, fraudulently billed Medicare millions of dollars for patients who were not really on the verge of dying (see here).

As you recall, the lower court judge struck down a $200 million False Claims Act (FCA) case against AseraCare, “holding that the government’s second guessing of physicians’ medical judgment alone cannot prove false claims.” Specifically, Judge Bowdre held that much of the evidence in the trial consisted merely of conflicting expert testimony about patient eligibility, and the federal government failed to prove its case, as “[a] mere difference of opinion between physicians, without more, is not enough to show falsity.” (US ex rel Paradies v AseraCare)

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