Federal Decision That Differences in Medical Opinion Are Not False Claims Act Violations

In an important win for hospice and other health care providers facing claims under the False Claims Act (FCA), a federal court in Alabama gave a summary judgment victory last week to hospice provider Aseracare Inc.

Key Takeaway

A difference in medical opinion between the Government’s expert physician and the physicians who certified a patient’s terminal illness did not establish the required element of “falsity” under the FCA.

Why this is Significant

This ruling is not limited to hospice providers, as the opinion states “[t]he court finds that contradiction based on clinical judgment or opinion alone cannot constitute falsity under the FCA as a matter of law.”

Source: Differences in Medical Opinion Are Not False Claims Act Violations NATIONAL LAW REVIEW

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