False Claims Act Research Paper

The False Claims Acts is the federal government’s primary civil remedy for improper or fraudulent claims. The False Claims Act prohibits activity that does not fall under the definition of fraud. Fraud is the actual knowledge and the intent to defraud. For example “On March 10,2000, the department of Justice filed claims under the FCA (False Claims Act) seeking recovery of over $1 billion from Vencor Inc., a long-term healthcare provider, for its alleged knowing submission of false claims. The Department of Justice alleged that Vencor was engaged in improper billing practices, claims for services never rendered, provision of medically unnecessary services, misrepresenting eligibility or credentials and substandard quality of life.” (Page 90)
This allows people who are not affiliated with the government to file actions against federal contractors claiming fraud against the government. The Stark Law prohibits physician referrals of designated health services if the physician has a financial relationship with that entity. Designated health services include physical therapy services, occupational therapy services, radiology, home health services, outpatient prescription drugs, inpatient and outpatient hospital services, radiation services, medical equipment and prosthetics. There are some exceptions to the Stark Law, for example, if a physician is practicing as part of a group practice, that physician can refer for services within the group