Quality of Care, Medical Necessity, and Worthless Services Under the False Claims Act: Where Are We Headed Now?

Known as "the most powerful tool . . . to deter and redress fraud," the False Claims Act ("FCA") has long been the federal government's key civil remedy to pursue federal money or property, such as Medicare reimbursement, federal subsidies and loans, and payments under contracts for goods and services. The government's use of the FCA in the health care sector has reaped substantial recoveries and it has been used to investigate a diverse range of activity, including the conduct of providers, hospitals, suppliers of durable medical equipment, clinical laboratories, pharmaceutical companies, long-term care facilities, and managed care organizations.