Dive Brief:

• The American Hospital Association and health insurance lobby AHIP filed a joint amicus brief on Tuesday to the U.S. Supreme Court in United States v. Supervalu Inc. v. Safeway Inc., arguing that the federal government’s “erroneous construction and expansion” of the False Claims Act would threaten “legitimate business activities of every government contractor, hospital, healthcare provider, health insurance provider, and grant recipient in the nation.”
• The False Claims Act has become a tool for federal prosecutors to crack down on healthcare fraud, especially schemes involving improper billing in federal health programs, and grants private citizens the ability to pursue alleged fraudsters on their own and file suits on behalf of the government. Settlements and judgments from the FCA exceeded $2 billion during the 2022 fiscal year, according to the Department of Justice.
• Of issue in the SCOTUS case is the FCA’s scienter element, or knowledge and nature of intent, involving legal liability when defendants file false claims. Lower court rulings have diverged on interpretation of intent, made more complex in a regulatory environment with “thousands of statutes,” according to the amicus brief.

Dive Insight:

The joint brief is a rare showing between two agencies that often represent dueling interests regarding federal health policy.

“While AHA and AHIP may not always share the same opinion on matters of litigation and policy, we agree that the current regulatory...

Read Full Story: https://news.google.com/rss/articles/CBMidmh0dHBzOi8vd3d3LmhlYWx0aGNhcmVkaXZl...