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Major healthcare associations jump into Supreme Court case about fraud
Modern Healthcare

More than a dozen major healthcare organizations and associations have jumped into a Supreme Court case over the validity of a legal theory now used to bring many fraud lawsuits against them.

The case has the potential to reduce—or increase—the number of False Claims Act suits brought against healthcare providers and other companies, depending on which way the high court rules.

Universal Health Services v. United States ex rel Escobar focuses on situations in which whistle-blowers allege providers have submitted false claims to government programs by failing to follow certain regulations. Providers are sometimes held liable even if the government never explicitly stated that following a regulation was a condition of payment, and even if the provider never explicitly vouched that it had complied with the regulation.