Medicare Coding FCA Decision Is A Plausibility Reminder
Law360 (August 29, 2019, 5:21 PM EDT) -- The recent federal court opinion issued by the U.S. District Court for the Western District of Texas in Integra Med Analytics LLC v. Baylor Scott & White Health illustrates the continued importance of examining the plausibility of allegations made in qui tam lawsuits by relators seeking enormous bounties under the federal False Claims Act.
On behalf of the United States (which chose not to intervene), Integra sued a prominent Texas hospital system — Baylor Scott & White Health — that operates a network of inpatient short-term acute care hospitals and four affiliates. Integra's qui tam suit claimed that the defendants systematically upcoded secondary...
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