Envision Healthcare, BestPractices Defeat Medicare Fraud Suit

Envision Healthcare Corp., BestPractices of West Virginia, and other defendants beat a whistleblower’s claims that they violated the False Claims Act by engaging in a upcoding scheme to overbill Medicare, the Fourth Circuit affirmed Wednesday.

Whistleblower Cortney Taylor didn’t plead with particularity that specific false claims were actually presented to the government for payment, Judge James Andrew Wynn of the US Court of Appeals for the Fourth Circuit said.

She claimed that BestPractices directed doctors to sign medical charts for patients only seen by mid-level providers, and obtained payments at a higher reimbursement rate than was warranted.

But an ...