QUI TAM ACTION - FALSE CLAIMS ACT
U.S. ex rel Kersulis v. Rehabcare Group, Inc., No. 4:00-CV-00636 GTE (E.D. Ark. Jan. 29, 2007)
The United States District Court for the Eastern District
of Arkansas granted a hospital summary judgment in a suit alleging violations
of the False Claims Act ("FCA") regarding the classification and billing of patients
in acute rehabilitation units. In the suit, a whistleblower employee of the hospital
alleged that the hospital had purposefully misclassified in order to bill Medicare
at more lucrative rates. The district court held that summary judgment was appropriate
because the Centers for Medicare & Medicaid Services ("CMS") did
not provide any formal guidance regarding the interpretation of the relevant
FCA regulations, which were unclear, and there was no evidence to show that the
hospital knowingly provided false information or caused false claims to be submitted
to the federal government.