George B. Breen, a Member of the Firm in the Health Care and Life Sciences and Litigation practices and Chair of the firm’s National Health Care and Life Sciences Practice Steering Committee, was quoted in Healthcare Dive, in “4 Huge Impacts of the King v. Burwell Decision,” by Katie Bo Williams.
Following is an excerpt:
Health economists have pegged the amount of healthcare spending at risk in this decision at between $15 billion and $22 billion—a huge amount of federal dollars that Epstein, Becker &
Green attorney George Breen says should serve as a reminder to providers of the enforcement mechanisms available to government through the exchanges.
“The ACA provides that the False Claims Act applies to payments by, through or in connection to an exchange if the payments involve federal funds,” Breen told Healthcare Dive. Because federal dollars are now indelibly connected to the exchanges through tax credits, there is an “increased risk of enforcement to the provider community,” he says. And under the ACA, the damages that providers could be subjected to in a False Claims case connected to an exchange increases to not less than three times—and up to as many as six.
“Today’s ruling, given that it has validated both federal and state exchanges, can be used as a reminder to providers of the increased exposure to False Claims Act liability,” Breen said.