Lexology January 17, 2024
In 2022, “[t]he government and whistleblowers were party to 351 settlements and judgments, the second highest number of settlements and judgments in a single year.” Notably, “health care fraud remained the leading source of False Claims Act settlements and judgments[.]” Insurers should be aware that an effort is underway in Congress to further boost FCA enforcement. The False Claims Amendments Act of 2023 (FCAA) would amend the FCA’s “materiality” requirement in a way that could pose challenges for managed care organizations.
Key takeaways
- FCA settlements and judgments, primarily in health care, are at near-record levels
- Post Escobar, bipartisan group of senators has introduced bill that would amend FCA’s materiality requirement, stating government’s decision to continue paying claims despite knowledge...
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