MEDICARE FRAUD: New Guidelines May Ease Hospital Probes
The U.S. Justice Department "has issued new guidelines limiting how federal prosecutors can pursue alleged Medicare fraud," a move made in response "to complaints of harassment from hospitals." The new rules require that federal prosecutors "first determine that hospitals knowingly submitted fraudulent claims before" attempting a prosecution under the False Claims Act. Justice officials insisted the guidelines "simply clarify the steps that prosecutors" should have been using all along (AP/Boston Globe, 6/6). Hospitals and other health care providers are asking Congress to pass legislation clarifying how the False Claims Act should be enforced. The Justice Department hinted earlier this year that it would clarify guidelines for prosecuting Medicare fraud.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.