虚假声明:美国政府对医疗保健行业的协调利用。

Journal of law and health Pub Date : 2022-01-01
Grady McMichen
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引用次数: 0

摘要

《虚假申报法》(FCA)在保护美国政府不受商人和其他提出还款要求的各方的欺骗方面有着悠久的历史。向参加医疗补助和医疗保险扩展计划的美国人提供与联邦政府相同的保护,将允许采取行动防止大型医院网络参与价格垄断行为。实施这一改革将降低所有美国人的医疗保健价格。在价格操纵层面适用《虚假申报法》将产生最大的影响;然而,对于涉及事实和法律虚假的个人索赔,制定程序仍然很重要。虽然乍一看,为这两种类型的虚假规定的不同要求似乎是相互矛盾的,但事实虚假和法律虚假之间显然没有重叠或分裂。然而,如果大规模诉讼是在FCA责任下提起的,国会或最高法院在适用这些不同标准时向下级法院提供指导是很重要的。建立FCA在事实和法律虚假情况下的责任要求,将允许医疗保健提供者制定遵守指南的计划。这一变化将减少不必要的医疗保健治疗和支出,将经济和身体健康的好处传递给美国人民。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
False Claims: The Coordinated Exploitation of the United States Government by the Healthcare Industry.

The False Claims Act (FCA) has a long-standing history of protecting the United States government from being defrauded by merchants and other parties submitting claims for repayment. Affording Americans who have enrolled in Medicaid and Medicare expansion plans the same protection afforded to the federal government will allow for action to be brought to prevent large hospital networks from engaging in price-fixing behaviors. Implementing this change will have the effect of reducing healthcare prices for all Americans. Applying the False Claims Act at the price-fixing level will have the largest affect; however, it is still important to iron out procedures for individual claims involving factual and legal falsity. Although the different requirements established for the two types of falsity at first glance appear to be contradictory to each other, it is clear there is no overlap or split between factual and legal falsity. However, if large scale litigation were brought under FCA liability, it is important for Congress or the Supreme Court to offer lower courts guidance in applying these distinct standards. Establishing requirements for FCA liability under factual and legal falsity will allow for healthcare providers to make plans to adhere to the guidance. This change will have the effect of reducing unnecessary healthcare treatments and spending, passing on financial and physical health benefits to the American people.

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