Court Dismisses Major False Claims Act Case Against Hospice Provider: Ruling Mere Difference of Medical Opinion is Insufficient to Prove a Claim is False

On March 31, 2016, the United States District Court for the Northern District of Alabama in U.S. ex rel. Paradies v. AseraCare, Inc. dismissed a major False Claims Act case against a national hospice provider after ruling that a mere difference of medical opinion is not enough to prove a claim is false.

The case involved allegations that hospice provider AseraCare had submitted false claims to Medicare by certifying patients as eligible for hospice care even though they did not have “a life expectancy of 6 months or less if the terminal illness runs its normal course” as required by federal regulations.  The court had previously decided to bifurcate the trial into two phases:  phase one would focus on whether the claims were legally false, and phase two would focus on all remaining issues, including AseraCare’s mental intent and the Government’s alleged damages.

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Jamie Lesnett

Jamie Lesnett

Jamie Lesnett focuses his practice on complex business litigation and government investigations. Mr. Lesnett has extensive experience litigating complex business disputes in federal and state courts throughout the United States, including litigation involving contract disputes, business torts, unfair competition and trade secret misappropriation. Mr. Lesnett also has extensive experience representing clients in internal investigations, government investigations and enforcement actions regarding business crimes and civil frauds, including healthcare fraud, securities fraud, the False Claims Act and government contract fraud.

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