Using the False Claims Act to Second-Guess What Patients Need



Mark Pearlstein and Laura McLane wrote this bylined article on government use of the False Claims Act against health care providers that allegedly submit false or fraudulent claims to Medicare or Medicaid. “Using the FCA—a fraud statute—to police questions of medical necessity except in very clear cases strays far from the statute’s intended purposes,” the authors wrote, and thus “render the FCA an ever-expanding booby trap of potentially catastrophic liability for providers of health care” in the US.