Question

Thoroughly discuss and analyze the False Claims Act. You should discuss the history of the FCA, prohibited actions, the elements, qui tam suits, recent cases, and how it will impact your role as a health care administrator.

Answer 1

False claim Act(FCA) enacted during the civil war, President Abraham lincoln advocated this. FCA to combat fraud from company or organization when sold supplies from the Union army. It has a Qui tam lawsuit that allows private citizens to sue, behalf pf government, individuals and companies when defrauding the government. Qui tam means action for the government and for the claim. FCA provisions prohibited qui tam lawsuits based on information from the federal government. It prevented whistleblowers from filing a lawsuit and any information about fraud has government filed even though the whistleblower is a source of government knowledge.it prohibited false claim for payment to the federal government and false record.. elements of FCA include defendant made a statement to get the government to pay money on a claim, the claim was false, the defendant knows the claim was false. the untrue statement or claim not sufficient warrant liability under the FCA, it must show the knowing fraud.
Qui tam lawsuit is a whistleblower lawsuit under FCA it rewards whistleblower for success case under the behalf of the government.
recent cases:
-Tuller Prebon case fined euro15,400,000 for breaches related to wholesale conduct and failure to cooperate with the trade sector.
-The prudential assurance company limited fined up to euro23,875,000 for misselling and made unfair treatment of customers in the pensions sector.
-Jin-Yi-lee fined euro214,300 for breaches of principles and disclosure rules in the insurers' sector.
these lawsuits threaten medical practice survival. The act makes the risk of massive civil damages and penalties. high health care cost makes this fraud against government sectors. as a health care administrator by a whistleblower they should efficiently combat health care fraud. they should be in the correct position to find fraudulent conduct and following qui tam lawsuits behalf of the government