As a doctor and practice owner, I urge caution in expanding Pennsylvania’s False Claims Act.
One reason I left the traditional insurance model was the constant threat of chargebacks and retroactive denials. Insurers create shifting rules where even minor documentation errors — a missing note, a line out of place — can trigger repayment demands or threats of litigation. The care is real and medically necessary, yet a paperwork slip becomes grounds to allege “fraud.” That climate drives providers away from patient care and could push more out of Pennsylvania.
I agree that intentional fraud must be punished and taxpayer dollars protected. But as typically structured, these laws often invite lawsuits where attorneys exploit honest mistakes, turning minor documentation issues into costly litigation and mass recoupments. This diverts time and resources from patient care, ultimately hurting Pennsylvania families and discouraging clinicians from practicing here.
We need balance: a system that punishes intentional fraud, safeguards taxpayers, and allows honest providers to care for patients without the constant fear of jackpot lawsuits over paperwork.
Dr.
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