I discussed the impact of a September 2024 court decision related to qui tam provisions under the False Claims Act (FCA) in an article published by the Health Care Compliance Association (HCCA). The article outlines predictions concerning enforcement trends for 2025.
One case having a broad effect on FCA enforcement is how the U.S. District Court for the Middle District of Florida ruled that the qui tam provision under the FCA is a violation of the U.S. Constitution. With this ruling, whistleblowers will face greater challengers to bring fraud lawsuits against companies. The ruling is already being challenged, but as I explained, this new interpretation is “an argument being added to every motion at every stage.”
The full article, “Outlook 2025: Look for MA Cases Based on Claim Denials; Incoming DOJ May Tweak Guidance,” was published by HCCA’s Report on Medicare Compliance (Volume 34, Number 1) on January 13 and is available online.