George B. Breen, Member of the Firm in the Health Care & Life Sciences and Litigation practices and Chair of the firm’s National Health Care & Life Sciences Practice Steering Committee, in the firm’s Washington, DC, office, was quoted in the Bloomberg BNA Health Care Daily Report, in “New False Claims Cases Press Patient Dumping Law Argument,” by Matt Phifer. (Read the full version – subscription required.)
Following is an excerpt:
A law intended to stop hospitals from turning patients away from emergency departments based on their insurance status or ability to pay is now being used as a tool in False Claims Act litigation.
A pair of false claims cases in Mississippi allege a novel liability theory: the hospitals didn’t provide emergency medical assistance to uninsured and Medicare-eligible patients as required by the Emergency Medical Treatment and Labor Act (EMTALA) and then charged the federal or state government for the services.
Whistleblower attorneys, ever on the watch for new and inventive False Claims Act (FCA) liability theories, are closely watching the cases to see if they get traction. Likewise, attorneys defending health-care providers against such accusations are monitoring the cases for insights on how to defend against allegations that the government would not have paid claims by providers that failed to adequately screen or treat the emergency room patients. …
George Breen, an attorney at Epstein Becker Green in Washington who represents health-care providers in false claims cases, echoed the defense team’s arguments, saying the Escobar decision seems to preclude the whistleblowers from using alleged EMTALA noncompliance for this purpose.
“There does not appear to be either an express or implied certification issue here,” Breen told Bloomberg Law. “Moveover, the FCA’s rigorous materiality standard, as noted in Escobar, cannot be satisfied ..."
“There are existing administrative remedies and the FCA was never intended to serve as the mechanism to address every potential regulatory violation; at best, that’s what the relators seek to do here,” Breen told Bloomberg Law.
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