Health Law & Business News

Medicare Fraud Claims Against Hospital Rejected by Tenth Circuit

Feb. 7, 2020, 7:30 PM

A whistleblower failed to show that Lawrence Memorial Hospital in Kansas violated the False Claims Act by engaging in two healthcare schemes to defraud Medicare, the Tenth Circuit ruled Friday.

Stacey Janssen didn’t show that the alleged schemes involved noncompliance that was material to government payment decisions, which is required for FCA liability, the U.S. Court of Appeals for the Tenth Circuit said. It affirmed a district court’s summary judgment ruling for the hospital.

The hospital’s alleged falsification of patient arrival times to increase Medicare reimbursements wasn’t material because Medicare continued to pay the hospital after learning about the allegations...

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