In Waller Lansden's Healthcare blog, attorneys Jim Mathis and Josh Collins note that the U.S. District Court for the Western District of Tennessee recently dismissed a qui tam suit brought against Baptist Medical Center in Memphis, Tenn., which alleged that Baptist violated the False Claims Act (FCA) by falsely certifying compliance with Medicare’s Conditions of Participation (CoPs). The court noted that, unlike Conditions of Payment, CoPs are not a prerequisite to a particular reimbursement. Alleged non-compliance with CoPs could lead to corrective action, but because the government would not have immediately withheld Medicare payments as a result of such deficiencies, they were neither material to payment nor so deficient as to constitute worthless services. Under the FCA, a false statement within a claim only makes the claim fraudulent if that statement influences the decision making body.
United States ex rel. Landers v. Baptist Mem’l Health Care Corp., No. 2:99-cv-2097 (W.D. Tenn. Dec. 17, 2007).
