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The government's use of the Civil False Claims Act to enforce standards of quality of care: ingenuity or the heavy hand of the 800-pound gorilla.

Michael M. Mustokoff, Jody A. Werner, Michael S. Yecies

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Abstract

Fraud and abuse issues abound in health care. A new, rather unique assertion is that submitting a bill for health care that is inadequate constitutes a violation of the Civil False Claims Act. The authors contend that there are more effective and appropriate ways to address poor quality of care, and that using the False Claims Act in this matter is like fitting a square peg in a round hole.

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What this paper is about

Fraud and abuse issues abound in health care. A new, rather unique assertion is that submitting a bill for health care that is inadequate constitutes a violation of the Civil False Claims Act. The authors contend that there are more effective and appropriate ways to address poor quality of care, and that using the False Claims Act in this matter is like fitting a square peg in a round hole.

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Available abstract

Fraud and abuse issues abound in health care. A new, rather unique assertion is that submitting a bill for health care that is inadequate constitutes a violation of the Civil False Claims Act. The authors contend that there are more effective and appropriate ways to address poor quality of care, and that using the False Claims Act in this matter is like fitting a square peg in a round hole.

Key concepts: Assertion, False Claims Act, Pound (networking), Health care, Ingenuity, Quality (philosophy), Government (linguistics), Law

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The government's use of the Civil False Claims Act to enforce standards of quality of care: ingenuity or the heavy hand of the 800-pound gorilla. — Research Paper | ScholarLens