Physicians who provide services under Medicare and other federal health care programs won’t face the possibility of civil lawsuits being brought against them for an unlimited period, thanks to a recent decision by the Supreme Court of the United States.
In KBR v. United States of America Ex Relator Benjamin Carter, petitioners sought to overturn earlier court decisions that would eliminate the existing six-year limit on damage claims under the federal False Claims Act. The U.S. Supreme Court ruling last week maintains the six-year limitation on damage claims—including those brought by “qui tam” plaintiffs who file lawsuits on behalf of the government—under the False Claims Act.
The ruling is significant because the False Claims Act, a Civil War-era statute, often is used to raise inappropriate claims against businesses, hospitals and other health care providers. The outcome of the court’s decision affects lawsuits brought by parties on behalf of the government for services provided under federally funded health care programs.
In a friend-of-the-court brief filed last year, the Litigation Center of the AMA and State Medical Societies pointed out that if the statute of limitations were removed, physicians could be “forced to defend against stale, repetitive and frequently meritless claims.” This task would require significant costs in maintaining records for an indefinite period, planning for unknown contingencies and defending against inappropriate suits.
The AMA long has expressed concern over ambiguities in the False Claims Act and previously has filed several court briefs reflecting concerns over this law.
Last year, physicians reaffirmed AMA policy recognizing the False Claims Act is often disproportionately applied to physicians. The policy calls for the AMA to lobby for modification or repeal of the False Claims Act and similar statutes.
Under the federal False Claims Act, the penalty for each claim is between $5,000 and $10,000, adjusted for inflation, plus three times the amount of damages “sustained by the federal government.” If information was misrepresented on multiple Medicare claims, for instance, penalties would apply to each claim—regardless of how small the billed amount was.
Read more about this case and other cases related to the False Claims Act at the Litigation Center Web page.
