Physicians and Physician Organizations Law Institute & Hospitals and Health Systems Law Institute: Why Quality of Care Should Matter to You – FCA Enforcement in 2013 and Beyond

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George B. Breen, Member of the Firm in the Health Care and Life Sciences and Litigation practices, copresents "Why Quality of Care Should Matter to You: False Claims Act Enforcement in 2013 and Beyond" at the American Health Lawyers Association's joint conference of the Physicians and Physician Organizations Law Institute and the Hospitals and Health Systems Law Institute, which runs from February 11 to February 13.

As physicians and hospitals assess their risk exposure for False Claims Act enforcement, one area of increasing concern is the government's pursuit of quality of care and worthless services cases. Already a part of enforcement efforts in the long term care industry, the government is steadily focused on the quality of the services provided to its beneficiaries and sees this as an area ripe for False Claims Act enforcement. The growing requirements of adherence to standards of quality, with recent emphasis on the measurement and reporting of quality indicators, including adverse outcomes, complications, mortality, etc., provides the government with additional data analytics with which to evaluate the quality of the services provided, and increases the risk of quality of care investigations and litigation.

This program will address the following:

  • The government's theory of FCA liability in "quality of care" and "worthless services" cases against hospitals and physicians
  • Challenging the government's effort to utilize the False Claims Act as a mechanism to enforce quality standards
  • What physicians and hospitals can do, proactively, to try to stave off this enforcement effort and how compliance programs should be adapted to address this risk area

For more information, visit American Health Lawyers Association.