Eleventh Circuit Decision Will Impact Health Care Fraud Investigations

An 11th Circuit opinion from late last year is a big win for healthcare providers, says attorney Kathleen McDermott in this Today’s General Counsel article. In its appeal, hospice care provider AseraCare prevailed in its demand for a new trial with its contention that flawed jury instructions allowed mere clinical disagreement to be the only evidence of falsity in ascertaining False Claims Act liability. “Lawyers defending healthcare providers love the AseraCare decision,” McDermott says. But she warns against complacency in clinical oversight, explaining why, and how, the board of directors, even more than the compliance officers, should play an important role in managing healthcare provider risk.