Earlier this month a judge overturned a judgment of
approximately $350 million in a False Claims Act case where a relator, which is
a person who brings a lawsuit on behalf of the government, accused a nursing
home operator of upcoding and failure to maintain care plans. See United States ex rel. Ruckh v. Rehabilitation, M.D.Fla. No. 8:11-cv-1303-T-23TBM, 2018 U.S. Dist. LEXIS
5148 (Jan. 11, 2018).
A Florida federal judge found there was not
evidence that the government would have declined payment if aware of alleged
billing violations. He concluded that the “defendants argue persuasively that
the relator failed to offer evidence of materiality, defined unambiguously and
required emphatically by Universal Health Services, Inc. v. Escobar, 136
S. Ct. 1989 (2016).
The court explained that the fact that the federal and state government continued to pay the defendants’ claims after learning of the allegations was fatal to the relator’s case.
The court explained that the fact that the federal and state government continued to pay the defendants’ claims after learning of the allegations was fatal to the relator’s case.
This judgment continues a trend of
courts taking the materiality requirements of Escobar seriously by
looking at what the government did after it learned of the allegations
underlying the alleged fraud.
No comments:
Post a Comment