FALSE CLAIMS ACT

US ex rel. Yeager v. Medquest Assoc., Inc., No. 1:03-cv-0777-MHT-TFM (M.D.Ala. Oct. 31, 2007)

The federal District Court for the Middle District of Alabama dismissed a qui tam false claims action against a diagnostic imaging center, holding that the employee-relator's failure to show that the imaging center knowingly presented any of the alleged false claims to the U.S. government for payment barred her from establishing the essential elements of a valid claim under the False Claims Act. The court found that the relator's allegations that the imaging center (1) improperly failed to collect Medicare copayments, (2) instructed employees to change diagnostic codes to ensure Medicare payments, and (3) used a Medicare provider number to receive payments for services provided in a second unauthorized building were unsupported by evidence, noting that, while the relator may have provided "the specifics as to some potential improper practices, she [was] unable to specifically show fraudulent submissions to the government."

Regarding the Medicare provider number claim, the court concluded that because the imaging center repaid the three Medicare claims from the second building that were inadvertently submitted under the first building's code, the relator was unable to show that the imaging center knowingly submitted a false claim, an essential element to her claim.