False claims act for Maryland
Maryland looks like it may become the 26th state to enact a full-fledged false claims act to clamp down on medical providers that defraud government programs. I attended a hearing on the issue before a senate committee this afternoon where proponents for the bill, SB 279, voiced strong arguments for the state to adopt this measure.
After a disappointing one-vote loss in the state senate last year, Gov. Martin O’Malley seems determined to have a better outcome for this false claims bill in 2010. He sent his lieutenant governor to the hearing along with a bevy of other top officials to make the case for this remedy that likely would add millions of dollars to the state treasury.
Sponsors also brought in officials from Delaware and Texas who recounted how well their states have fared using false claims acts. They also countered arguments put forth by opponents that enacting this new remedy would lead to frivolous lawsuits and a litigation explosion. Experience in other states suggests these are hollow arguments.
Leading up to the hearing, O’Malley reached out to medical providers in the state to try to ease some of their reservations for his proposal, including adding compromises to the legislation. Further amendments likely will be added, but hopefully none that will weaken its impact.
The Coalition issued a statement supporting the bill, saying it would serve as a deterrent and a powerful incentive for medical providers to have strong compliance programs and to “play by the rules.” False claims acts help detect fraudulent schemes that otherwise might not ever be known because they allow insiders to blow the whistle and initiate civil actions. Since the mid-1980s governments have recovered more than $20 billion from health care organizations through false-claim actions.
February 23rd, 2010 at 10:56 pm
Sure is a funny thing. When I tried to get the State Insurance agency to go after well over a quarter of a million dollars of Insurance and Mail fraud all I got was a giggling government employee at the end of the phone.
February 24th, 2010 at 7:00 am
The downside to another weapon in the government’s hands to use against providers is the abuse of power issue. I was a victim 8 years ago. I fired an employee who was related to someone working in the Texas Atty. Gen. office and they started a 3-year investigation that destroyed my practice. The AG pulled in the IRS and FBI and made unfounded allegations to my patients, even threatening some with the presence of their guns. After 3 years the FBI called and said I could go to their office and pick up all the boxes they had collected. No formal challenges were made. The FBI said my practice was “too big” (we employed 15 mental health therapists) and billed a million a year. I have never fully recovered from that nightmare.