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.
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