Bradley attorney Jason Mehta was quoted in Bloomberg BNA on more nonmedical provider companies finding themselves involved in healthcare fraud lawsuits. More FCA actions are focusing on nonprovider entities that are associated or transact business with healthcare providers, and these nonprovider entities need to be aware of the potential for liability.
“If you are a provider that is even tangentially involved in federal health care, you need to be careful,” said Mehta. Nonprovider entities “really need to focus on what payment arrangements you have with your medical providers” because they can trigger potential FCA liability for that nonprovider.
Mehta explained that the key to preventing FCA liability in these arrangements is to focus on Stark self-referral law and anti-kickback law issues. “By focusing on these concerns, and running to the ground any possible problems, providers can negate an inference of intentional conduct,” he said.
Mehta added that nonproviders involved in federal healthcare programs should “really scrutinize the top billers” in their provider affiliates. It’s important to find out why certain providers are billing outliers, and be able to explain to government investigators why those providers are such high billers.
The complete article, “ Health-Care Fraud Cases Catching More Than Just Medical Providers,” appeared in Bloomberg BNA on January 31, 2018.