March 4, 2020 / 11:31 PM / a month ago

Whistleblowers don't need to prove doctors' judgment was 'falsehood' - 3rd Circuit

A U.S. appeals court on Tuesday ruled that whistleblowers do not have to prove that a doctor’s judgment was an “objective falsehood” in order to pursue claims that a prognosis led to false claims for Medicare reimbursement, deepening a circuit split.

A unanimous three-judge panel of the 3rd U.S. Circuit Court of Appeals, ruling on an issue of first impression, revived a 2008 lawsuit by former employees of hospice care provider Care Alternatives who say the company violated the False Claims Act (FCA) by routinely admitting patients who were not eligible for hospice care, based on physician evaluations that were not supported by medical evidence.

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