Courts Rejecting Connection Between FCA, Medical Necessity

Overview


Rebecca Martin and Laura McLane wrote this bylined article on recent court rulings which held that a mere difference of opinion between physicians is not enough to establish falsity under the False Claims Act. The authors called the rulings “welcome developments for providers, who often confront both audits and FCA actions premised on alleged lack of medical necessity, even in situations where physicians vigorously disagree about the appropriate course of treatment.”