A photo illustration shows a general practitioner holding a stethoscope. REUTERS/Regis Duvignau
(Reuters) - The U.S. Supreme Court on Monday signaled continued interest in a whistleblower suit involving allegations of systemic exaggeration of Medicare patients’ ailments, asking Solicitor General Elizabeth Prelogar to weigh in on the level of detail required to plead fraud “with particularity” under the False Claims Act.
Tejinder Singh of the Sparacino firm, representing quality-assurance nurse Cathy Owsley, urged the high court to review an October ruling of the 6th U.S. Circuit Court of Appeals to resolve a split among the circuits about whether the law requires plaintiffs to provide information about specific instances of overbilling.
The justices in January asked for the solicitor general’s views on a similar petition filed by Singh in a different whistleblower case, Johnson v. Bethany Hospice, but Prelogar has not yet responded.
In both cases, Singh argues that seven circuits take a flexible approach, while five others require higher levels of detail or actual examples of padded invoices.
In Owsley’s case, the 6th Circuit acknowledged that she had offered “considerable detail” about upcoding practices by her employer, Envisions Healthcare subsidiary Care Connection of Cincinnati, and a third-party coding contractor, Fazzi Associates. However, the court said she had not provided enough information about specific invoices “she thinks were fraudulent” — and “for that...
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