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.