New York State has agreed to settle a federal False Claims lawsuit with the federal government which alleged that the state had overbilled Medicaid recipients and approved requests for home care for the elderly, frail, and disabled without getting the required documentation first. See New YorkTimes article at: http://www.nytimes.com/2011/11/01/nyregion/new-york-settles-medicaid-fraud-suit-for-70-million.html.
Some fear that the settlement will lead to reluctance on the part of medical care providers to authorize personal care services.
The False Claims Act provides for triple damages if a Medicaid claim is found to have been paid in error or been overpaid. Therefore, providers need to be very careful about how they approach Medicaid claims and make sure they complete the paperwork and steps required to support a Medicaid claim.
The bringing of the lawsuit and the size of the settlement signal the seriousness of the federal government in enforcing the False Claims Act. The climate created by the law may impact lawsuit plaintiffs seeking healthcare services, among other elderly, frail, or disabled patients. It may become harder for lawsuit plaintiffs to obtain needed medical services, and it may take longer for payment and paperwork to be completed.
