On August 1st
Representatives Howard Coble (R-NC) and David Scott (D-GA) introduced a bill in
the House of Representatives which aims to limit the exposure hospitals may
face under a False Claims Act (“FCA”) suit.
In particular, the bill, if enacted, would amend the FCA to ensure that
unintentional billing issues are not penalized as fraud under the FCA.
If enacted,
this would be a considerably step towards reducing the risk associated with
billing and other unintentional errors that impact hospitals through the
FCA. Recently,
the University of Pittsburgh Medical Center and a joint venture settled a FCA
allegation related to a billing error for just under $1 million. In addition, fifty-five (55)
hospitals settled FCA allegations regarding inappropriate billing for more
than $34 million in July.
Hospitals
and health care organizations should still be mindful of FCA exposure, as this
bill has yet to be enacted.
Nevertheless, all hospitals and health care organizations should have an
established compliance program to assist their organization in reducing FCA,
Stark Law, and Anti-Kickback Statute risk.
If you would
like additional information or have any questions regarding this bill or the
issues discussed, please contact Robert A. Wade
at (574) 485-2002 or Alex T. Krouse
at (574) 485-2003.