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Are Allegations of Lack of Medical Necessity in False Claims Act Cases a Basis for Settlement or Trial?

<b><i>Lessons Learned from Recent Settlements and Decisions</b></i><p>Health care fraud and False Claims Act cases continue to generate a significant source of funds for the Federal Government.Although, when announcing its focus, the government listed treatment options are not always clear. What these settlements often have in common is that the underlying complaints allege that the services that were rendered and reimbursed lacked medical necessity.

11 minute read October 01, 2018 at 12:09 AM
By
Jacqueline C. Wolff
Are Allegations of Lack of Medical Necessity in False Claims Act Cases a Basis for Settlement or Trial?

Health care fraud and False Claims Act cases continue to generate a significant source of funds for the Federal Government. During Fiscal Year 2017, the Federal Government won or settled over $2.4 billion in health care fraud judgments and settlements, most of which went into the Medicare Trust or Treasury.

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