Sean McKenna in Law360: FCA Risks Soar As Medicare Unseals Doc Billing Records


Medicare’s epic release Wednesday of millions of physician reimbursement records is a seminal moment of transparency that will likely galvanize False Claims Act litigation for years to come, experts say.

The sprawling database catalogs nearly $80 billion that the federal government doled out to 880,000 professionals in 2012. Even if only a small fraction of those providers come in for FCA scrutiny, the impact could be tremendous...

There are at least a couple of major ways the data are likely to fuel fraud investigations. In one scenario, media reports may call attention to suspect billing, prompting inquiries by the U.S. Department of Justice, the Office of Inspector General at the U.S. Department of Health and Human Services, and CMS.

“There will be pressure for DOJ and OIG and CMS to take a look at those billings more closely now that this is public,” said Sean McKenna, a partner at Haynes and Boone, LLP.

Excerpted from Law360, April 10, 2014. To view full article, click here (subscription required).

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