Squire Patton Boggs attorneys recently published an article that discussed three anti-fraud elements of the Affordable Care Act (ACA) regarding maintaining financial integrity of the health insurance exchanges. Looking at those provisions, some may erroneously conclude that the ACA dramatically increased the damages that may be imposed for false claims made in connection with the exchanges. The article analyzes the three anti-fraud elements and concludes that only two made it into law: (1) the FCA is explicitly applicable to the exchanges; and (2) the conditions of eligibility for an insurer are material to the company’s entitlement to payments. The effort to impose treble-treble damages failed to make it into law, even though it was included in the legislation that passed.
