DOJ Addicted To Failed FCA Theory, Hospital Chain Says

Law360 (June 17, 2019, 7:30 PM EDT) -- The U.S. Department of Justice is clinging to a discredited False Claims Act theory that improperly imposes stricter billing standards in privately run Medicare Advantage than traditional government-run Medicare, California hospital chain Sutter Health said Friday.

In a motion to dismiss, Sutter and its Palo Alto Medical Foundation affiliate knocked the government for pursuing a whistleblower manager's FCA case that targets billing for unsupported diagnoses of Medicare Advantage beneficiaries. The case echoes failed attempts by the government to punish unsupported billing by Medicare Advantage insurers even though the government doesn't punish equivalent rates of unsupported billing in traditional Medicare, Friday's motion...

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California Northern

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Other Statutes: False Claims Act

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Date Filed

March 6, 2015

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